Adept Hospice Care
Organization Active NPI Community Based Hospice Care Agency · Redlands, CA
NPI 1013401074 · NPPES record last updated Jun 21, 2018
Key facts
- NPI
- 1013401074
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- ADEPT HOSPICE CARE
- Practice address
- 515 New Jersey St.
Suite G
Redlands, CA 92373 - Phone
- (818) 281-5906
- Fax
- (888) 544-2759
- NPI assigned
- Jun 21, 2018
- Organization subpart
- No
Authorized official
- Name
- Ms. Cecilia Godoy
- Title
- President
- Phone
- (818) 281-5906
Owners & managing parties with NPI records 3
-
Cecilia Godoy, PT, DPT
-
Eufrocino Cabotaje Martinez, M. D.
Practitioners 2
-
Cecilia Godoy, PT, DPT
Affiliated clinicians 1
-
Hicham Siouty, MD
Medicare Care Compare: Hospice
- Listed as
- Adept Hospice Care
- Ownership
- For-Profit
- Certified
- Feb 2, 2021
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Hospice certification: CCN A11572
- Legal name
- ADEPT HOSPICE CARE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Feb 2, 2021
- Last certification
- Feb 2, 2021
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation · Proprietary
- Enrollment address
- 10737 Laurel St
Ste 130
Rancho Cucamonga, CA 91730-3837
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Eufrocino Martinez |
Contracted Managing Employee |
May 1, 2026 | 100% |
| Emmanuel CZ Clemente |
5% Or Greater Direct Ownership Interest | Mar 15, 2024 | 33% |
| Corporate Officer |
Mar 3, 2018 | 100% | |
| W-2 Managing Employee |
Mar 15, 2024 | 100% | |
| Cecilia T Godoy |
Contracted Managing Employee |
Mar 3, 2018 | 100% |
| 5% Or Greater Direct Ownership Interest |
Mar 15, 2024 | 34% | |
| Corporate Officer |
Mar 3, 2018 | 100% | |
| Corporate Director |
Mar 3, 2018 | 100% | |
| Donnie Salcedo |
5% Or Greater Direct Ownership Interest | Mar 15, 2024 | 33% |
| Corporate Officer |
Mar 3, 2018 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190628002836 | CA | Part a Provider - Hospice | 8820322597 | Practice locations: Rancho Cucamonga, CA |
National Provider Directory
Locations
9267 Haven Ave
Ste 275
Rancho Cucamonga, CA 91730
Phone (909) 748-0010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
515 New Jersey St.
Suite G
Redlands, CA 92373
Mailing address
515 New Jersey St.
Suite G
Redlands, CA 92373
Phone (818) 281-5906
Other providers in Redlands, CA
- Leila Adab
- Meena Adami
- Mustafa Adami
- Julius Adeyinka Oluwatunayo Adegoke Sr.
- John Adeniji
- Anita Corina Adorador
- Advanced Ambulatory Surgery Center, LLC
- Advanced Sleep Medicine Services, Inc.
- Aegis Treatment Centers, LLC
- Aeneas Treatment & Wellness Center
All providers in Redlands, CA · Community Based Hospice Care Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.