Organization Active NPI

Agape Hospice Care, Inc.

  • Community Based Hospice Care Agency
  • Simi Valley, CA
National Provider Identifier
1366082349
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
AGAPE HOSPICE CARE, INC.
Practice address
5924 E Los Angeles Ave Ste L
Simi Valley, CA 93063-5526
Phone
(714) 326-5589
NPI assigned
Jan 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Authorized official

Name
Oneille Garcia
Title
Ceo/President
Phone
(714) 326-5587

Specialties & licenses 1

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

Addresses

Primary practice location

5924 E Los Angeles Ave Ste L
Simi Valley, CA 93063-5526

Mailing address

5924 E Los Angeles Ave Ste L
Simi Valley, CA 93063-5526

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL WEBSITE Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211223001121 CA Part A Provider - Hospice 1153712369 Practice locations: Simi Valley, CA

Hospice certification: CCN B41734

Legal name
AGAPE HOSPICE CARE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 28, 2022
Last certification
Oct 13, 2022
Organization structure
CorporationProprietary
Incorporated
Sep 16, 2019 in CA
Enrollment address
5924 E Los Angeles Ave
Ste L
Simi Valley, CA 93063-5526

Care Compare: Hospice

Medicare Care Compare
Listed as
Agape Hospice Care, IncCCN B41734
Certified
Oct 28, 2022
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
05D2196695Agape Hospice Care, Inc5924 East Los Angeles Avenue Suite L, Simi Valley, CA 93063Certificate of waiverOct 18, 2026

National Provider Directory

National Provider Directory

Locations

5924 E Los Angeles Ave
Ste L
Simi Valley, CA 93063
Phone (805) 422-8760

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.

NameRoleSinceShare
Romeo O Gumba Individual 5% Or Greater Direct Ownership InterestOwner/ Governing Body Sep 16, 2019 25%
Corporate OfficerCfo Nov 9, 2019 100%
Corporate DirectorBoard of Director Nov 9, 2019 100%
Maria Socorro a Gumba Individual 5% Or Greater Direct Ownership InterestOwner/ Governing Body Sep 16, 2019 25%
Corporate DirectorBoard of Director Nov 9, 2019 100%
Oneille Garcia Individual 5% Or Greater Direct Ownership InterestOwner/ Governing Body Nov 4, 2019 25%
Corporate OfficerCeo/President Nov 9, 2019 100%
Corporate DirectorBoard of Director Nov 9, 2019 100%
Maria Clariza Vasquez Garcia Individual 5% Or Greater Direct Ownership InterestOwner/ Governing Body Sep 16, 2019 25%
Corporate OfficerSecretary Nov 9, 2019 100%
Corporate DirectorBoard of Director Nov 9, 2019 100%
W-2 Managing EmployeeAdmin Designee/DPCS Desginee Nov 9, 2019 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1578441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1366082349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5924 E LOS ANGELES AVE STE L",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930635526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5924 E LOS ANGELES AVE STE L",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930635526",
            "telephone_number": "714-326-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "ONEILLE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "714-326-5587"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WEBSITE",
            "affiliation": "N",
            "endpointDescription": "WEBSITE",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "EMAIL",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "EMAIL",
            "address_1": "5924 E Los Angeles Ave Ste L",
            "city": "Simi Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930635526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.