Organization Active NPI

Bristol Hospice - Inland Valley, L.L.C.

  • Community Based Hospice Care Agency
  • Ontario, CA
National Provider Identifier
1013318112
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BRISTOL HOSPICE - INLAND VALLEY, L.L.C.
Practice address
1520 N Mountain Ave Ste 206
Ontario, CA 91762-1133
Phone
(909) 256-3245
Fax
(909) 912-8232
NPI assigned
Sep 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alex Mauricio
Title
President and Ceo
Phone
(801) 325-0175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

1520 N Mountain Ave Ste 206
Ontario, CA 91762-1133

Mailing address

206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741
Phone (801) 325-0175

Other names 1

  • All Saints Hospice, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211013002845 CA Part A Provider - Hospice 6800294364 Practice locations: Rancho Cucamonga, CA

Hospice certification: CCN 751690

Legal name
BRISTOL HOSPICE - INLAND VALLEY, L.L.C.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 28, 2015
Last certification
Aug 30, 2018
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Aug 19, 2020 in DE
Enrollment address
7365 Carnelian St
Ste 240
Rancho Cucamonga, CA 91730-1136

Care Compare: Hospice

Medicare Care Compare
Listed as
Bristol Hospice - Inland Valley LLCCCN 751690
Ownership
For-Profit
Certified
Jul 28, 2015
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2088162Bristol Hospice Inland Valley LLC1520 N Mountain Ave BLDG E Ste 206, Ontario, CA 91762Certificate of waiverDec 10, 2026

National Provider Directory

National Provider Directory

Locations

1520 N Mountain Ave
Ste 206
Ontario, CA 91762
Phone (626) 775-7888

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bristol Hospice Holdings Inc Organization, Salt Lake City, UT Corporation, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 30, 2021 100%
Alex Edward Mauricio Individual Corporate OfficerPresident Ceo Jun 1, 2022
Corporate DirectorDirector Jan 1, 2023
Operational/Managerial ControlPresident Ceo Jun 1, 2022
Webster Equity Partners Bristol CF LP Organization, Waltham, MA Investment firm 5% Or Greater Indirect Ownership Interest Jan 20, 2022 69.8%
Stephen Torres Individual W-2 Managing EmployeeAd; Feb 10, 2025
John Charles Garbarino Individual Corporate OfficerSecretary/Treasurer Sep 30, 2021
Corporate Director Sep 30, 2021
Webster Equity Partners IV Bristol CF LP Organization, Waltham, MA Investment firm 5% Or Greater Indirect Ownership Interest Jan 20, 2022 5.72%
Michael Derrick Individual Corporate OfficerCfo Sep 1, 2023
Betty J Brennan Individual Corporate DirectorDirector Jul 13, 2018
Bristol Ultimate Holdco, LP Organization, Salt Lake City, UT Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 20, 2022 100%
Hyrum Kirton Individual Corporate DirectorDirector Oct 26, 2020
Aware Super Pty, LTD. Organization, Sydney, IN LLC, Investment firm 5% Or Greater Indirect Ownership Interest Jan 24, 2022 8.28%
Wilbert T Tsai Individual Contracted Managing EmployeeMedical Director May 1, 2021
Bristol Hospice, L.L.C. Organization, Salt Lake City, UT LLC, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 30, 2021 100%
Bristol Hospice Topco Inc Organization, Salt Lake City, UT Corporation, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 30, 2021 100%
David a Malm Individual Corporate OfficerVice President Sep 30, 2021
Corporate Director Sep 30, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 52

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 52

Practitioners & affiliated clinicians

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771804800000",
    "number": "1013318112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N 2100 W STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841164741",
            "telephone_number": "801-325-0175",
            "fax_number": "801-478-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N MOUNTAIN AVE STE 206",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917621133",
            "telephone_number": "909-256-3245",
            "fax_number": "909-912-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL HOSPICE - INLAND VALLEY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A",
        "authorized_official_last_name": "MAURICIO",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "801-325-0175"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "All Saints Hospice, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.