NPIMap

Organization Active NPI

Mohave Healthcare, Inc.

Doing business as River Valley Hospice

  • Community Based Hospice Care Agency
  • Parker, AZ
National Provider Identifier
1568828804
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HSPC 7364 Issued in AZ
Legal business name
MOHAVE HEALTHCARE, INC.
Doing business as
River Valley Hospice
Practice address
1317 S Joshua Ave Ste P
Parker, AZ 85344-5754
Phone
(928) 457-0100
Fax
(520) 333-3068
NPI assigned
Dec 31, 2015
Last updated
Jan 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Amber L Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HSPC 7364 AZ Primary

Addresses

Primary practice location

1317 S Joshua Ave Ste P
Parker, AZ 85344-5754

Mailing address

1317 S Joshua Ave Ste P
Parker, AZ 85344-5754
Phone (928) 457-0100

Other names 1

  • River Valley Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160126000284 AZ Part A Provider - Hospice 5799091104 Practice locations: Parker, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568828804. Details of each certification follow.

Hospice certification: CCN 031639

Legal name
MOHAVE HEALTHCARE INC
Doing business as
RIVER VALLEY HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 27, 2015
Last certification
May 7, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jun 23, 2015 in NV
Enrollment address
1317 S Joshua Ave
Ste P
Parker, AZ 85344-5754

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
River Valley HospiceCCN 031639 · All quality measures
Ownership
For-Profit
Certified
Aug 27, 2015
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
03D2098403River Valley Hospice1317 S Joshua Ave Ste P, Parker, AZ 85344Certificate of waiverJul 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Mohave Healthcare Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1317 S Joshua Ave
Ste P
Parker, AZ 85344
Phone (928) 457-0100

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Matthew Briggs Individual W-2 Managing EmployeeAdministrator Designee May 31, 2023
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation 5% Or Greater Direct Ownership Interest Dec 31, 2015 100%
Sandra Copsey Individual W-2 Managing EmployeeAd;Executive Director/Administrator Mar 1, 2022
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Brent Guerisoli Individual Corporate DirectorDirector and Sole Board Member Jun 9, 2022
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2019 100%
John J Gochnour Individual Corporate OfficerPresident Jun 12, 2024
Ronald D Parker Individual Contracted Managing EmployeeMD; Oct 1, 2015
Amber Tueller Individual Corporate OfficerSecretary Jun 12, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

NPI Registry JSON

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1568828804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 S JOSHUA AVE STE P",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853445754",
            "telephone_number": "928-457-0100",
            "fax_number": "520-333-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 S JOSHUA AVE STE P",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853445754",
            "telephone_number": "928-457-0100",
            "fax_number": "520-333-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAVE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-31",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AZ",
            "license": "HSPC 7364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Valley Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parker, AZ

Sources for this page

Verify at the official NPI Registry.