Organization Active NPI

Melody Care Hospice

  • Community Based Hospice Care Agency
  • Upland, CA
National Provider Identifier
1730764531
Registry record updated Apr 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MELODY CARE HOSPICE
Practice address
876 N Mountain Ave Ste 102
Upland, CA 91786-4166
Phone
(909) 931-9277
NPI assigned
Mar 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2024

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

Authorized official

Name
Archibon Lamaria
Title
President
Phone
(909) 931-9277

Specialties & licenses 1

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

Addresses

Primary practice location

876 N Mountain Ave Ste 102
Upland, CA 91786-4166

Mailing address

876 N Mountain Ave Ste 102
Upland, CA 91786-4166
Phone (909) 931-9277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220103001748 CA Part A Provider - Hospice 4385035245 Practice locations: Upland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730764531. Details of each certification follow.

Hospice certification: CCN B31731

Legal name
MELODY CARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 13, 2022
Last certification
Apr 13, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jan 31, 2021 in CA
Enrollment address
600 N Mountain Ave
Ste A106
Upland, CA 91786-4359

Care Compare: Hospice

Medicare Care Compare
Listed as
Cypress HospiceCCN B31731 · All quality measures
Certified
Apr 13, 2022
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
05D2322995Melody Care Hospice876 N Mountain Ave Suite 102, Upland, CA 91786Certificate of waiverApr 29, 2027

National Provider Directory

National Provider Directory

Locations

876 N Mountain Ave
Ste 102
Upland, CA 91786
Phone (909) 931-9277

600 N Mountain Ave
Ste A106
Upland, CA 91786
Phone (323) 388-3510

Ownership & related parties

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.

NameRoleSinceShare
Donata Martinez Lamaria Individual 5% Or Greater Direct Ownership InterestPresident/Vice President/Secretary Jan 21, 2021 100%
Corporate OfficerPresident/Vice-President/Secretary Jan 21, 2021 100%
Corporate DirectorPresident/Vice President/Secretary Jan 21, 2021 100%
W-2 Managing EmployeePresident/Vice-President/Secretary Jan 21, 2021 100%
Archibon M Lamaria Individual Corporate OfficerManager Jan 21, 2021
W-2 Managing EmployeeManager Jan 21, 2021

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712448000000",
    "number": "1730764531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 N MOUNTAIN AVE STE 102",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864166",
            "telephone_number": "909-931-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 N MOUNTAIN AVE STE 102",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864166",
            "telephone_number": "909-931-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELODY CARE HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A",
        "authorized_official_last_name": "LAMARIA",
        "authorized_official_first_name": "ARCHIBON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-931-9277"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.