Bristol Hospice - Utah II, L.L.C.
Organization Active NPI Community Based Hospice Care Agency · Murray, UT
NPI 1619253606 · NPPES record last updated Feb 23, 2026
Key facts
- NPI
- 1619253606
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- BRISTOL HOSPICE - UTAH II, L.L.C.
- Practice address
- 1106 E 6600 S Ste 100
Murray, UT 84121-2446 - Phone
- (801) 930-5266
- Fax
- (801) 930-5272
- NPI assigned
- Oct 23, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- BRISTOL HOSPICE, L.L.C.
Authorized official
- Name
- Alex Mauricio
- Title
- Ceo
- Phone
- (801) 325-0175
Owners & managing parties with NPI records 1
-
Richard E Allen, M.D.
Facilities with the same owner 52
Affiliated clinicians 1
-
Valarie D Jacobs, APRN
Medicare Care Compare: Hospice
- Listed as
- Bristol Hospice - Utah II, LLC
- Ownership
- For-Profit
- Certified
- Jul 26, 2012
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Hospice certification: CCN 461595
- Legal name
- BRISTOL HOSPICE - UTAH II, LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jul 26, 2012
- Last certification
- Apr 21, 2021
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Jul 11, 2011 in UT
- Enrollment address
- 1106 E 6600 S
Murray, UT 84121-2446
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Bristol Hospice Holdings Inc |
5% Or Greater Indirect Ownership Interest | Sep 26, 2018 | 100% |
| Alex Edward Mauricio |
Corporate Officer |
Jan 1, 2023 | |
| Corporate Director |
Sep 1, 2023 | ||
| Webster Equity Partners Bristol CF LP |
5% Or Greater Indirect Ownership Interest | Sep 1, 2023 | 76.82% |
| John Charles Garbarino |
Corporate Officer |
Sep 1, 2023 | |
| Corporate Director |
Sep 26, 2018 | ||
| Webster Equity Partners IV Bristol CF LP |
5% Or Greater Indirect Ownership Interest | Sep 1, 2023 | 6.43% |
| Michael Derrick |
Corporate Officer |
Sep 1, 2023 | |
| Betty J Brennan |
Corporate Director |
Jul 13, 2018 | |
| Julee Wolf |
W-2 Managing Employee |
Feb 1, 2024 | |
| Bristol Ultimate Holdco, LP |
5% Or Greater Indirect Ownership Interest | Sep 1, 2023 | 100% |
| Richard E Allen |
Contracted Managing Employee |
Jul 2, 2018 | |
| Hyrum Kirton |
Corporate Director |
Oct 26, 2020 | |
| Bristol Hospice, L.L.C. |
5% Or Greater Direct Ownership Interest | Sep 26, 2018 | 100% |
| Bristol Hospice Topco Inc |
5% Or Greater Indirect Ownership Interest | Sep 26, 2018 | 100% |
| David a Malm |
Corporate Officer |
Sep 1, 2023 | |
| Corporate Director |
Sep 26, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120125000638 | UT | Part a Provider - Hospice | 1658548003 | Practice locations: Murray, UT |
National Provider Directory
- Part of
- Bristol Hospice LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
1106 E 6600 S Ste 100
Murray, UT 84121-2446
Mailing address
206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741
Phone (801) 325-0175
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619253606 | Medicaid | UT |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | regulatory@bristolhospice.com | Direct |
Other providers in Murray, UT
- Brighton Medical Group
- Brightstar Healthcare
- Catalina Brigman
- Jaime Bringhurst
- W Robert Brinton
- Camille Britton
- Madalyn Brobak
- Harold Grant Brockbank
- Lori P Brockbank
- Wells Brockbank
All providers in Murray, UT · Community Based Hospice Care Agency in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.