E.C. Lilly Palliative Care and Hospice Agency, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

E.C. LILLY PALLIATIVE CARE AND HOSPICE AGENCY, INC.

Practice address

1942 Del Paso Rd Ste 130-100
Sacramento, CA 95834-7718

Phone

(916) 993-6358

Fax

(916) 514-8580

NPI assigned

Jan 27, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Lilia Andallo Retuta

Title

President

Phone

(323) 387-8169

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B31581

Legal name

E. C. LILLY PALLIATIVE CARE AND HOSPICE AGENCY, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 12, 2021

Last certification

Dec 12, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jul 24, 2018 in CA

Enrollment address

1942 Del Paso Rd
Ste 130-100
Sacramento, CA 95834-7718

Listed as

Ec Lilly Palliative Care & Hospice Agency, IncCCN B31581

Certified

Dec 12, 2021

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 1

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

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

{
    "created_epoch": "1548547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548547200000",
    "number": "1861956575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 DEL PASO RD STE 130-100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958347718",
            "telephone_number": "916-993-6358",
            "fax_number": "916-514-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 DEL PASO RD STE 130-100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958347718",
            "telephone_number": "916-993-6358",
            "fax_number": "916-514-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E.C. LILLY PALLIATIVE CARE AND HOSPICE AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-27",
        "last_updated": "2019-01-27",
        "status": "A",
        "authorized_official_last_name": "RETUTA",
        "authorized_official_first_name": "LILIA",
        "authorized_official_middle_name": "ANDALLO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-387-8169",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2019; 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.