Debentz Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DEBENTZ INC.

Doing business as

Cherry Blossom Hospice

Practice address

536 Barstow Rd
Barstow, CA 92311-2908

Phone

(951) 979-2539

Fax

(951) 979-2540

NPI assigned

May 17, 2016

Last updated

May 17, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lou Parcon Benitez

Title

President

Phone

(951) 956-3591

Specialties & licenses 1

Addresses

Other names 1

• Cherry Blossom Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861849093. Details of each certification follow.

• CCN A01667 Hospice · Active · Details

Hospice certification: CCN A01667

Legal name

DEBENTZ INC

Doing business as

CHERRY BLOSSOM HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 16, 2019

Last certification

Aug 16, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Feb 24, 2016 in CA

Enrollment address

536 Barstow Rd
Barstow, CA 92311-2908

Listed as

Cherry Blossom HospiceCCN A01667 · All quality measures

Ownership

For-Profit

Certified

Aug 16, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Kenneth Carl Russ, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Desert Hot Springs, CA
  • NPI 1245258235

  Contracted Managing Employee

  CMS ownership

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1861849093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 BARSTOW RD",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923112908",
            "telephone_number": "951-979-2539",
            "fax_number": "951-979-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 BARSTOW RD",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923112908",
            "telephone_number": "951-979-2539",
            "fax_number": "951-979-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBENTZ INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "BENITEZ",
        "authorized_official_first_name": "LOU",
        "authorized_official_middle_name": "PARCON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-956-3591",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cherry Blossom Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul Dang, PHARMD
• Allison Daum
• Nichole Day
• Maria De Haro
• Laarni Itliong Debelen
• Rosario Deking
• Yoleysis Delacruz
• Gladys Delgado
• Nichole Delgado
• Elizabeth Jane Demagno, MD

• Home Health Agency in Barstow, CA
• Providers in Barstow, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.