Allied Hospice Care,Inc.
Organization Active NPI Community Based Hospice Care Agency · Chatsworth, CA
NPI 1225699697 · NPPES record last updated Jun 26, 2019
Key facts
- NPI
- 1225699697
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- ALLIED HOSPICE CARE,INC.
- Practice address
- 21757 Devonshire St Ste 12
Chatsworth, CA 91311-2960 - Phone
- (818) 280-5331
- Fax
- (818) 280-5339
- NPI assigned
- Jun 26, 2019
- Organization subpart
- No
Authorized official
- Name
- Mr. Lord Yaun
- Title
- Ceo
- Phone
- (818) 280-5331
Medicare Care Compare: Hospice
- Listed as
- Allied Hospice Care, Inc
- Ownership
- For-Profit
- Certified
- Jan 9, 2021
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Hospice certification: CCN B21696
- Legal name
- ALLIED HOSPICE CARE INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jan 9, 2021
- Last certification
- Jan 9, 2021
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation · Proprietary
- Incorporated
- Apr 9, 2019 in CA
- Enrollment address
- 21757 Devonshire St
Ste 12
Chatsworth, CA 91311-2960
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Jocelyn Valle |
W-2 Managing Employee |
Apr 9, 2019 | |
| Lennard Joseph Valle |
5% Or Greater Direct Ownership Interest |
Apr 9, 2019 | 33.33% |
| Corporate Officer |
Apr 9, 2019 | ||
| Corporate Director |
Apr 9, 2019 | ||
| Jameson Suarez |
5% Or Greater Direct Ownership Interest |
Apr 9, 2019 | 33.33% |
| Corporate Officer |
Apr 9, 2019 | ||
| Corporate Director |
Apr 9, 2019 | ||
| Lord Karlette Yaun |
5% Or Greater Direct Ownership Interest | Apr 9, 2019 | 33.34% |
| Corporate Officer |
Apr 9, 2019 | ||
| Corporate Director |
Apr 9, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200504000034 | CA | Part a Provider - Hospice | 1355772575 | Practice locations: Chatsworth, CA |
National Provider Directory
Locations
21757 Devonshire St
Ste 12
Chatsworth, CA 91311
Phone (818) 280-5331
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
21757 Devonshire St Ste 12
Chatsworth, CA 91311-2960
Mailing address
21757 Devonshire St Ste 12
Chatsworth, CA 91311-2960
Phone (818) 280-5331
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.