Green Valley Hospice & Paliative Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

GREEN VALLEY HOSPICE & PALIATIVE CARE INC

Practice address

19031 US Highway 18
Ste 160
Apple Valley, CA 92307-2515

Phone

(760) 242-0088

Fax

(760) 242-0077

NPI assigned

Oct 8, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Amalia D Raya, REGISTERED NURSE

Title

Administrator

Phone

(760) 220-0390

Specialties & licenses 1

Addresses

Other names 1

• GREEN VALLEY HOSPICE & PALLIATIVE CARE, INC. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 921604

Legal name

GREEN VALLEY HOSPICE & PALIATIVE CARE INC

Doing business as

GREEN VALLEY HOSPICE AND PALLIATIVE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 29, 2017

Last certification

Nov 5, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Aug 27, 2014 in CA

Enrollment address

19031 Hwy 18
Suite 160
Apple Valley, CA 92307-2515

Listed as

Green Valley Hospice & Palliative Care, LLCCCN 921604

Ownership

For-Profit

Certified

Mar 29, 2017

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 5

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

Affiliated clinicians 2

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

• Arash Milani, MD

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1043581317

  Hospice

  Care Compare affiliation
• Hari M. Reddy, M.D.

  • Family Medicine Physician
  • Victorville, CA
  • NPI 1811232911

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1154724854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19031 US HIGHWAY 18",
            "address_2": "STE 160",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072515",
            "telephone_number": "760-242-0088",
            "fax_number": "760-242-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19031 US HIGHWAY 18",
            "address_2": "STE 160",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072515",
            "telephone_number": "760-242-0088",
            "fax_number": "760-242-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN VALLEY HOSPICE & PALIATIVE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "RAYA",
        "authorized_official_first_name": "AMALIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "760-220-0390",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREEN VALLEY HOSPICE & PALLIATIVE CARE, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Grace Grant, PA-C
• Jennifer Marie Lewis Grant, LMFT, LPCC
• Green Bridge Living Inc.
• Green Paradise Adult Home Care LLC.
• Green Valley Homehealth Services, Inc
• Jason Green
• Mack Green, MD
• Emily Grezenski, OTR/L
• Louise Gricol, MA, CTRS
• Kenneth Grier, M.D.

• Community Based Hospice Care Agency in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.