Active NPI
Holistic Hospice Care, Inc.
Doing business as Angelicare Hospice
- Community Based Hospice Care Agency
- Chino, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- HOLISTIC HOSPICE CARE, INC.
- Doing business as
- Angelicare Hospice
- Practice address
- 12598 Central Ave Ste 212
Chino, CA 91710-3530 - Phone
- (888) 552-3202
- Fax
- (888) 552-3793
- NPI assigned
- Oct 13, 2017
- Last updated
- Feb 6, 2025
- 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
- Nora Iskandar
- Title
- Owner
- Phone
- (347) 355-4164
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
12598 Central Ave Ste 212
Chino, CA 91710-3530
Mailing address
12598 Central Ave Ste 212
Chino, CA 91710-3530
Phone (888) 552-3202
Other names 1
- Angelicare Hospice
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181129002230 | CA | Part A Provider - Hospice | 4082958251 | Practice locations: Chino, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1770094054. Details of each certification follow.
Hospice certification: CCN A01696
- Legal name
- HOLISTIC HOSPICE CARE, INC.
- Doing business as
- ANGELICARE HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Dec 12, 2019
- Last certification
- Dec 12, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Sep 26, 2017 in CA
- Enrollment address
- 12598 Central Ave
Ste 212
Chino, CA 91710-3530
Care Compare: Hospice
Medicare Care Compare- Listed as
- Angelicare Hospice
- Ownership
- For-Profit
- Certified
- Dec 12, 2019
- 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 |
|---|---|---|---|
| 05D2289319 | Holistic Hospice Care Inc | Certificate of waiver | Sep 7, 2027 |
National Provider Directory
National Provider DirectoryLocations
12598 Central Ave
Ste 212
Chino, CA 91710
Phone (888) 552-3202
341 W 2nd St
Ste 8
San Bernardino, CA 92401
Phone (909) 300-0508
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 |
|---|---|---|---|
| Nora Iskandar | 5% Or Greater Direct Ownership Interest | Sep 1, 2021 | 33.5% |
| Corporate Officer | Sep 1, 2021 | 33.5% | |
| W-2 Managing Employee | Sep 1, 2021 | 33.5% | |
| Gene J Mabasa | 5% Or Greater Direct Ownership Interest | Sep 1, 2021 | 33.5% |
| Corporate Officer | Sep 1, 2021 | 33.5% | |
| W-2 Managing Employee | Sep 1, 2021 | 33.5% | |
| Mariam Mangyan | W-2 Managing Employee | Apr 16, 2022 | 100% |
| Eric R Presser | Contracted Managing Employee | Oct 16, 2022 | 100% |
| Michael Tadros | 5% Or Greater Direct Ownership Interest | Sep 1, 2021 | 33% |
| Corporate Officer | Sep 1, 2021 | 33% | |
| W-2 Managing Employee | Sep 1, 2021 | 33% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Rancho Mirage, CA
- NPI 1548279755
Contracted Managing Employee
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Yorba Linda, CA
- NPI 1720460330
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Rancho Mirage, CA
- NPI 1548279755
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507852800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738800000000",
"number": "1770094054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12598 CENTRAL AVE STE 212",
"city": "CHINO",
"state": "CA",
"postal_code": "917103530",
"telephone_number": "888-552-3202",
"fax_number": "888-552-3793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12598 CENTRAL AVE STE 212",
"city": "CHINO",
"state": "CA",
"postal_code": "917103530",
"telephone_number": "888-552-3202",
"fax_number": "888-552-3793"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLISTIC HOSPICE CARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2017-10-13",
"last_updated": "2025-02-06",
"certification_date": "2025-02-06",
"status": "A",
"authorized_official_last_name": "ISKANDAR",
"authorized_official_first_name": "NORA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "347-355-4164"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Angelicare Hospice",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Chino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.