Rosedove Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ROSEDOVE INC

Doing business as

Serenity Hospice Care

Practice address

1420 N Claremont Blvd Ste 104a
Claremont, CA 91711-3583

Phone

(909) 624-0100

Fax

(909) 624-0606

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Simreth Gill, RN

Title

Director of Patient Care Services

Phone

(800) 919-6419

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Serenity Hospice Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 051765

Legal name

ROSEDOVE INC

Doing business as

SERENITY HOSPICE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 8, 2003

Last certification

Dec 13, 2018

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Feb 13, 2002 in CA

Enrollment address

1420 N Claremont Blvd
Ste 104a
Claremont, CA 91711-3583

Listed as

Serenity Hospice CareCCN 051765 · All quality measures

Ownership

For-Profit

Certified

Nov 8, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 4

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 2

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

• Warren Regh C. Gabrillo III, M.D.

  • Family Medicine Physician
  • Upland, CA
  • NPI 1982689295

  Contracted Managing Employee

  CMS ownership
• Cong Thanh Phan, M.D.

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1386778033

  Contracted Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cynthia D Williams, LVN

  • Licensed Vocational Nurse
  • Pomona, CA
  • NPI 1578148672
  NPD

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Warren Regh C. Gabrillo III, M.D.

  • Family Medicine Physician
  • Upland, CA
  • NPI 1982689295

  Hospice

  Care Compare affiliation
• Cong Thanh Phan, M.D.

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1386778033

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1972585180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N CLAREMONT BLVD STE 104A",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113583",
            "telephone_number": "909-624-0100",
            "fax_number": "909-624-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N CLAREMONT BLVD STE 104A",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113583",
            "telephone_number": "909-624-0100",
            "fax_number": "909-624-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEDOVE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "SIMRETH",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT CARE SERVICES",
        "authorized_official_telephone_number": "800-919-6419",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER ID#",
            "identifier": "HPC01765F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Hospice Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Serenity Hospice Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Ralph Rogers Jr., PHD
• Doris Ingrid Rojas, D.D.S.
• Jazmine Evelyn Rayan Romero, DPT
• Alyssa Rosales
• Sylvia Marie Rosales, LVN
• Erica Florence Rosenfeld, PH.D.
• Alicia Roth, PA
• Jeanne M Roy, M.A., M.F.T.
• Stephanie J Rubi
• Mario Ruiz, PMHNP-BC

• Community Based Hospice Care Agency in Claremont, CA
• Providers in Claremont, 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 Sep 19, 2024; 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.