Active NPI
Lake Forest Hospice
- Community Based Hospice Care Agency
- Lake Forest, CA
National Provider Identifier
1174059513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- LAKE FOREST HOSPICE
- Practice address
- 22772 Centre Dr Ste 200
Lake Forest, CA 92630-6303 - Phone
- (949) 305-0057
- NPI assigned
- May 4, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Serafin G Aguirre
- Title
- President
- Phone
- (949) 305-0057
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | CA | Primary |
Addresses
Primary practice location
22772 Centre Dr Ste 200
Lake Forest, CA 92630-6303
Mailing address
22772 Centre Dr Ste 200
Lake Forest, CA 92630-6303
Phone (949) 305-0057
Other names 1
- LAKE FOREST HOSPICE & PALLATIVE CARE
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170509000937 | CA | Part A Provider - Hospice | 8224315809 | Practice locations: Lake Forest, CA |
Hospice certification: CCN A01738
- Legal name
- LAKE FOREST HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Feb 6, 2020
- Last certification
- Feb 6, 2020
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Enrollment address
- 22772 Centre Dr
Ste 200
Lake Forest, CA 92630-6303
Care Compare: Hospice
Medicare Care Compare- Listed as
- Lake Forest Hospice
- Ownership
- For-Profit
- Certified
- Feb 6, 2020
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
22772 Centre Dr
Ste 200
Lake Forest, CA 92630
Phone (949) 305-0057
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Serafin G Aguirre | 5% Or Greater Direct Ownership Interest | Sep 1, 2024 | 25% |
| Corporate Officer | Sep 1, 2024 | 25% | |
| Corporate Director | Sep 1, 2024 | 25% | |
| W-2 Managing Employee | Sep 1, 2024 | ||
| Marissa B Cera | 5% Or Greater Direct Ownership Interest | Sep 1, 2024 | 25% |
| Corporate Officer | Sep 1, 2024 | 25% | |
| Corporate Director | Sep 1, 2024 | 25% | |
| W-2 Managing Employee | Sep 1, 2024 | 25% | |
| Maria E Ledesma | 5% Or Greater Direct Ownership Interest | Sep 1, 2024 | 25% |
| Corporate Officer | Sep 1, 2024 | 25% | |
| Corporate Director | Sep 1, 2024 | 25% | |
| W-2 Managing Employee | Sep 1, 2024 | 25% | |
| Marissa E Tong | 5% Or Greater Direct Ownership Interest | Sep 1, 2024 | 25% |
| Corporate Officer | Sep 1, 2024 | 25% | |
| Corporate Director | Sep 1, 2024 | 25% | |
| W-2 Managing Employee | Sep 1, 2024 | 25% |
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": "1493856000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1767744000000",
"number": "1174059513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22772 CENTRE DR STE 200",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926306303",
"telephone_number": "949-305-0057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22772 CENTRE DR STE 200",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926306303",
"telephone_number": "949-305-0057"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKE FOREST HOSPICE",
"organizational_subpart": "NO",
"enumeration_date": "2017-05-04",
"last_updated": "2026-01-07",
"certification_date": "2026-01-07",
"status": "A",
"authorized_official_last_name": "AGUIRRE",
"authorized_official_first_name": "SERAFIN",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "949-305-0057",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "LAKE FOREST HOSPICE & PALLATIVE CARE",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lake Forest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.