Southland Hospice Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SOUTHLAND HOSPICE INC.

Practice address

12295 Osborne St
Pacoima, CA 91331-2001

Phone

(818) 745-7081

Fax

(818) 600-9250

NPI assigned

Aug 30, 2019

Organization subpart

No

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

Authorized official

Name

Hasmik Bagdasarian

Title

Ceo

Phone

(818) 745-7081

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN A11645

Legal name

SOUTHLAND HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 14, 2020

Last certification

Oct 14, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

12295 Osborne St
Pacoima, CA 91331-2001

Listed as

Southland Hospice IncCCN A11645 · All quality measures

Ownership

For-Profit

Certified

Oct 14, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

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.

• Jeffrey Shukhman, D.O.

  • Internal Medicine Physician
  • Woodland Hills, CA
  • NPI 1447593660

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Silva Karchikian, MD

  • General Practice Physician
  • Glendale, CA
  • NPI 1922010388

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608508800000",
    "number": "1205484375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12295 OSBORNE ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913312001",
            "telephone_number": "818-745-7081",
            "fax_number": "818-600-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12295 OSBORNE ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913312001",
            "telephone_number": "818-745-7081",
            "fax_number": "818-600-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND HOSPICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-30",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A",
        "authorized_official_last_name": "BAGDASARIAN",
        "authorized_official_first_name": "HASMIK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-745-7081"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina Marie Solis
• Stephanie Margit Sonn, LMFT
• Sue Novack Sorensen, LCSW
• Jose G Sosa I
• Nicole Anntoinette Sosa, MFT
• Shamar Spencer
• Larry Jermaine Spinks, LMFT
• Jaelyn Sprague
• St. Anthony's Adhc, Inc.
• Megan Stanley, MSW

• Community Based Hospice Care Agency in Pacoima, CA
• Providers in Pacoima, 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 Dec 21, 2020; 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.