Active NPI
Agape Hospice Care, Inc.
- Community Based Hospice Care Agency
- Simi Valley, CA
National Provider Identifier
1366082349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | WEBSITE | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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, Inc
- Certified
- Oct 28, 2022
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2196695 | Agape Hospice Care, Inc | Certificate of waiver | Oct 18, 2026 |
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Romeo O Gumba | 5% Or Greater Direct Ownership Interest | Sep 16, 2019 | 25% |
| Corporate Officer | Nov 9, 2019 | 100% | |
| Corporate Director | Nov 9, 2019 | 100% | |
| Maria Socorro a Gumba | 5% Or Greater Direct Ownership Interest | Sep 16, 2019 | 25% |
| Corporate Director | Nov 9, 2019 | 100% | |
| Oneille Garcia | 5% Or Greater Direct Ownership Interest | Nov 4, 2019 | 25% |
| Corporate Officer | Nov 9, 2019 | 100% | |
| Corporate Director | Nov 9, 2019 | 100% | |
| Maria Clariza Vasquez Garcia | 5% Or Greater Direct Ownership Interest | Sep 16, 2019 | 25% |
| Corporate Officer | Nov 9, 2019 | 100% | |
| Corporate Director | Nov 9, 2019 | 100% | |
| W-2 Managing Employee | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.