Centennial Group LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

8419HPC-0 Issued in NV

Legal business name

CENTENNIAL GROUP LLC

Doing business as

Centennial Hospice

Practice address

4535 W Sahara Ave
Suite 108
Las Vegas, NV 89102-3625

Phone

(702) 527-5553

NPI assigned

Feb 13, 2016

Organization subpart

No

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

Authorized official

Name

Mark Canlas AntolinNPI 1275491581

Title

Manager

Phone

(213) 590-4690

Specialties & licenses 1

Addresses

Other names 1

• Centennial Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Hospice certification: CCN 291549

Legal name

CENTENNIAL GROUP LLC

Doing business as

CENTENNIAL HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 8, 2016

Last certification

Aug 15, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Mar 15, 2015 in NV

Enrollment address

5613 S Eastern Ave
Las Vegas, NV 89119-2322

Listed as

Centennial HospiceCCN 291549 · All quality measures

Ownership

For-Profit

Certified

Sep 8, 2016

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 2

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

Practitioners 1

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

• Mark Canlas Antolin

  • Personal Care Attendant
  • Las Vegas, NV
  • NPI 1275491581
  NPD Authorized official

Affiliated clinicians 1

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

• Arlene Cuizon Rillo, M.D

  • Family Medicine Physician
  • Henderson, NV
  • NPI 1508276254

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1455321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1609235050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8589 SILVER COAST ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891396799",
            "telephone_number": "323-423-9950",
            "fax_number": "702-965-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 W SAHARA AVE",
            "address_2": "SUITE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891023625",
            "telephone_number": "702-527-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-13",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "ANTOLIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "CANLAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "213-590-4690"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NV",
            "license": "8419HPC-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centennial Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centennial Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Centennial Hills Mental Health LLC

• Community Based Hospice Care Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community Based Hospice Care Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.