Avery Care Hospice,Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

AVERY CARE HOSPICE,INC.

Practice address

11030 Arrow Rte Ste 209
Rancho Cucamonga, CA 91730-4837

Phone

(909) 727-3200

NPI assigned

Apr 18, 2020

Organization subpart

No

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

Authorized official

Name

Jose Antonio Yrribari

Title

Ceo

Phone

(909) 727-3200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B21617

Legal name

AVERY CARE HOSPICE INC

Certification status

Terminated Voluntary: merger or closure, May 8, 2026

Provider type (POS)

Hospice

Participating since

Jun 25, 2021

Last certification

Jun 25, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Feb 13, 2020 in CA

Enrollment address

11030 Arrow Rte
Ste 209
Rancho Cucamonga, CA 91730-4837

Listed as

Avery Care Hospice IncCCN B21617

Ownership

For-Profit

Certified

Jun 25, 2021

Medicare certification status

Terminated Voluntary: merger or closure, May 8, 2026From the Provider of Services file

Locations

All disclosed owners & managing parties 2

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

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

{
    "created_epoch": "1587168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587168000000",
    "number": "1548880685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11030 ARROW RTE STE 209",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304837",
            "telephone_number": "909-727-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11030 ARROW RTE STE 209",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304837",
            "telephone_number": "909-727-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERY CARE HOSPICE,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-18",
        "last_updated": "2020-04-18",
        "certification_date": "2020-04-18",
        "status": "A",
        "authorized_official_last_name": "YRRIBARI",
        "authorized_official_first_name": "JOSE ANTONIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-727-3200"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 Apr 18, 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.