Active NPI
Life Springs Hospice Care Inc.
- Community Based Hospice Care Agency
- Fremont, CA
National Provider Identifier
1609158476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- LIFE SPRINGS HOSPICE CARE INC.
- Practice address
- 60 Whitney PL
Fremont, CA 94539-7662 - Phone
- (510) 623-1561
- NPI assigned
- Sep 16, 2011
- 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
- Mrs. Alphie De Guzman
- Title
- President/Ceo
- Phone
- (510) 623-1561
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
60 Whitney PL
Fremont, CA 94539-7662
Mailing address
60 Whitney PL
Fremont, CA 94539-7662
Phone (510) 623-1561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111114000764 | CA | Part A Provider - Hospice | 3476727249 | Practice locations: Fremont, CA |
Hospice certification: CCN 551660
- Legal name
- LIFE SPRINGS HOSPICE CARE INC.
- Doing business as
- LIFE SPRINGS HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Nov 15, 2012
- Last certification
- Aug 27, 2021
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Jun 30, 2011 in CA
- Enrollment address
- 60 Whitney PL
Fremont, CA 94539-7662
Care Compare: Hospice
Medicare Care Compare- Listed as
- Life Springs Hospice Care
- Ownership
- For-Profit
- Certified
- Nov 15, 2012
- 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 |
|---|---|---|---|
| 05D2034939 | Life Springs Hospice Care | Certificate of waiver | Jan 5, 2028 |
National Provider Directory
National Provider DirectoryLocations
60 Whitney Pl
Fremont, CA 94539
Phone (510) 623-1561
Ownership & related parties
All disclosed owners & managing parties 5
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 |
|---|---|---|---|
| Alphian Batoon | Corporate Officer | Jun 30, 2011 | |
| Elpidio Magalong | Contracted Managing Employee | Sep 1, 2021 | 100% |
| Vanessa Estal Milana | W-2 Managing Employee | Apr 14, 2022 | 100% |
| Mario I de Guzman | Corporate Officer | Jun 30, 2011 | |
| Alphie E de Guzman | 5% Or Greater Direct Ownership Interest | Jun 30, 2011 | 100% |
| Corporate Officer | Jun 30, 2011 | ||
| Operational/Managerial Control | Jun 30, 2011 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Alameda, CA
- NPI 1992773279
Contracted Managing Employee
Practitioners & affiliated clinicians
Affiliated clinicians 3
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": "1316131200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1316131200000",
"number": "1609158476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 WHITNEY PL",
"city": "FREMONT",
"state": "CA",
"postal_code": "945397662",
"telephone_number": "510-623-1561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 WHITNEY PL",
"city": "FREMONT",
"state": "CA",
"postal_code": "945397662",
"telephone_number": "510-623-1561"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFE SPRINGS HOSPICE CARE INC.",
"organizational_subpart": "NO",
"enumeration_date": "2011-09-16",
"last_updated": "2011-09-16",
"status": "A",
"authorized_official_last_name": "DE GUZMAN",
"authorized_official_first_name": "ALPHIE",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "510-623-1561",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.