Organization Active NPI

Marys Help Hospice Services

  • Community Based Hospice Care Agency
  • Vallejo, CA
National Provider Identifier
1467060574
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MARYS HELP HOSPICE SERVICES
Practice address
3469 Tennessee St Ste 101
Vallejo, CA 94591-4908
Phone
(707) 645-7447
NPI assigned
Jul 15, 2020
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Mr. Warren Delfin, RN
Title
Owner/President
Phone
(650) 581-1359

Specialties & licenses 1

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

Addresses

Primary practice location

3469 Tennessee St Ste 101
Vallejo, CA 94591-4908

Mailing address

3469 Tennessee St Ste 101
Vallejo, CA 94591-4908
Phone (707) 645-7447

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210211001049 CA Part A Provider - Hospice 7315352085 Practice locations: Vallejo, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467060574. Details of each certification follow.

Hospice certification: CCN B51744

Legal name
MARYS HELP HOSPICE SERVICES
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 23, 2023
Last certification
Mar 23, 2023
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Mar 8, 2018 in CA
Enrollment address
3469 Tennessee St
Ste 103
Vallejo, CA 94591-4908

Care Compare: Hospice

Medicare Care Compare
Listed as
Mary's Help Hospice ServicesCCN B51744 · All quality measures
Certified
Mar 23, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

3469 Tennessee St
Ste 103
Vallejo, CA 94591
Phone (707) 645-7447

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Warren S Delfin Individual 5% Or Greater Direct Ownership InterestPresident/Ceo Mar 8, 2018 100%
Corporate Director Mar 8, 2018
W-2 Managing EmployeePresident/Ceo Jan 25, 2021 50%

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": "1594771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1467060574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3469 TENNESSEE ST STE 101",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945914908",
            "telephone_number": "707-645-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3469 TENNESSEE ST STE 101",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945914908",
            "telephone_number": "707-645-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYS HELP HOSPICE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "DELFIN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "650-581-1359",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.