Organization Active NPI

Bless Care Hospice Inc

  • Community Based Hospice Care Agency
  • Glendale, CA
National Provider Identifier
1104403476
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BLESS CARE HOSPICE INC
Practice address
726 W Broadway Ste B
Glendale, CA 91204-1054
Phone
(747) 215-6622
Fax
(747) 215-6622
NPI assigned
Mar 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
Hakob Hovsepyan
Title
Owner, Ceo, Cfo, Secretary
Phone
(747) 215-6622

Specialties & licenses 1

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

Addresses

Primary practice location

726 W Broadway Ste B
Glendale, CA 91204-1054

Mailing address

726 W Broadway Ste B
Glendale, CA 91204-1054
Phone (747) 215-6622

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210902002934 CA Part A Provider - Hospice 7214333079 Practice locations: Glendale, CA

Hospice certification: CCN B51626

Legal name
BLESS CARE HOSPICE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 10, 2023
Last certification
Jan 10, 2023
Organization structure
CorporationProprietary
Enrollment address
726 W Broadway St
Unit B
Glendale, CA 91204-1054

Care Compare: Hospice

Medicare Care Compare
Listed as
Bless Care Hospice IncCCN B51626
Certified
Jan 10, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

726 W Broadway
Ste B
Glendale, CA 91204
Phone (747) 215-6622

1800 Broadview Dr
Ste 266A
Glendale, CA 91208
Phone (747) 264-9804

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.

NameRoleSinceShare
Jeffrey Shukhman Individual Contracted Managing EmployeeMD; Dec 1, 2023
W-2 Managing EmployeeMD; Dec 1, 2023
Agasi Nazaryan Individual Contracted Managing EmployeeAd; May 27, 2024
W-2 Managing EmployeeAd; May 27, 2024
Shi Tang Individual W-2 Managing EmployeeMD;MD Designee Apr 1, 2026 10%
Anna Peterson Individual W-2 Managing EmployeeDPCS/Admin Dec 1, 2025 100%
Hakob Hovsepyan Individual 5% Or Greater Direct Ownership InterestCeo/Cfo/Secretary Jan 20, 2021 100%
Corporate OfficerCeo/Cfo/Secretary Jan 20, 2021 100%
Corporate DirectorCeo/Cfo/Secretary Jan 20, 2021 100%
W-2 Managing EmployeeCeo/Cfo/Secretary Jan 20, 2021 100%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 1

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

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": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1104403476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 W BROADWAY STE B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041054",
            "telephone_number": "747-215-6622",
            "fax_number": "747-215-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 W BROADWAY STE B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041054",
            "telephone_number": "747-215-6622",
            "fax_number": "747-215-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLESS CARE HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "HOVSEPYAN",
        "authorized_official_first_name": "HAKOB",
        "authorized_official_title_or_position": "OWNER, CEO, CFO, SECRETARY",
        "authorized_official_telephone_number": "747-215-6622"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.