Organization Active NPI

Galveston Hospice Care LLC

  • Community Based Hospice Care Agency
  • Katy, TX
National Provider Identifier
1033876735
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
GALVESTON HOSPICE CARE LLC
Practice address
26717 Westheimer Pkwy Ste 303
Katy, TX 77494-8058
Phone
(346) 661-0358
Fax
(832) 307-1011
NPI assigned
Nov 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Maria Cerisse Molato-Olila
Title
Administrator
Phone
(346) 661-0358

Specialties & licenses 1

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

Addresses

Primary practice location

26717 Westheimer Pkwy Ste 303
Katy, TX 77494-8058

Mailing address

26717 Westheimer Pkwy Ste 303
Katy, TX 77494-8058
Phone (346) 661-0358

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220523001581 TX Part A Provider - Hospice 0446637912 Practice locations: Katy, TX

Hospice certification: CCN A91516

Legal name
GALVESTON HOSPICE CARE LLC
Doing business as
CLOVERLEAF HOSPICE AND PALLIATIVE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 29, 2022
Last certification
Jun 29, 2022
Organization structure
LLCProprietary
Incorporated
Nov 9, 2021 in TX
Enrollment address
26717 Westheimer Pkwy BLDG 3 Suite 303
Katy, TX 77494-8058

Care Compare: Hospice

Medicare Care Compare
Listed as
Cloverleaf Hospice and Palliative CareCCN A91516 · All quality measures
Certified
Jun 29, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

15022 FM 529 Rd
Ste D
Houston, TX 77095
Phone (346) 400-6651

26717 Westheimer Pkwy
Ste 303
Katy, TX 77494
Phone (346) 661-0358

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Czarina Lagman Individual 5% Or Greater Direct Ownership InterestAlt. Administrator Jul 30, 2024 50%
W-2 Managing EmployeeAlternate Administrator Jul 30, 2024 50%
Aaliya Amer Individual Contracted Managing EmployeeMD; Aug 1, 2024
Maria Cerisse Molato-Olila Individual 5% Or Greater Direct Ownership InterestAdministrator Jul 30, 2024 50%
W-2 Managing EmployeeAd; Jul 30, 2024 50%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1033876735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26717 WESTHEIMER PKWY STE 303",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948058",
            "telephone_number": "346-661-0358",
            "fax_number": "832-307-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26717 WESTHEIMER PKWY STE 303",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948058",
            "telephone_number": "346-661-0358",
            "fax_number": "832-307-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALVESTON HOSPICE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MOLATO-OLILA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "CERISSE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "346-661-0358"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.