Arbor Vitae Hospice Care, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ARBOR VITAE HOSPICE CARE, INC.

Practice address

1780 Town and Country Dr Ste 106
Norco, CA 92860-3618

Phone

(951) 735-3485

Fax

(951) 735-0900

NPI assigned

Dec 12, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Faro T. Owiesy, M.DNPI 1568464048

Title

Medical Director

Phone

(951) 907-8111

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 751565

Legal name

ARBOR VITAE HOSPICE CARE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 8, 2014

Last certification

Dec 17, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Oct 10, 2011 in CA

Enrollment address

1780 Town and Country Dr
Ste 106
Norco, CA 92860-3618

Listed as

Arbor Vitae Hospice Care, IncCCN 751565

Ownership

For-Profit

Certified

May 8, 2014

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

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

• Faro Owiesy, M.D

  • Family Medicine Physician
  • Corona, CA
  • NPI 1568464048

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Faro Owiesy, M.D

  • Family Medicine Physician
  • Corona, CA
  • NPI 1568464048
  NPD Authorized official

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Faro Owiesy, M.D

  • Family Medicine Physician
  • Corona, CA
  • NPI 1568464048

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1578831129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 MAGNOLIA AVE",
            "address_2": "STE. 106",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 TOWN AND COUNTRY DR STE 106",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603618",
            "telephone_number": "951-735-3485",
            "fax_number": "951-735-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBOR VITAE HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "OWIESY",
        "authorized_official_first_name": "FARO",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-907-8111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Norco",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1780 Town and Country Dr Ste 106",
            "city": "Norco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928603618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community Based Hospice Care Agency in Norco, CA
• Providers in Norco, 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 Sep 29, 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.