Haven Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HAVEN HOSPICE, INC.

Practice address

525 N Brand Blvd Ste 105
Glendale, CA 91203-3991

Phone

(818) 422-2422

NPI assigned

Sep 15, 2020

Organization subpart

No

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

Authorized official

Name

Vardges Paylevanyan

Title

Ceo

Phone

(818) 422-2422

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B31623

Legal name

HAVEN HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 19, 2021

Last certification

Nov 19, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 28, 2020 in CA

Enrollment address

2605 1/2 W Beverly Blvd
Montebello, CA 90640-2309

Listed as

Haven Hospice, IncCCN B31623 · All quality measures

Certified

Nov 19, 2021

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.

Affiliated clinicians 2

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

• Sami A Nafoosi, MD

  • Internal Medicine Physician
  • Lancaster, CA
  • NPI 1164713244

  Hospice

  Care Compare affiliation
• Martin Zapata, D.O

  • Internal Medicine Physician
  • Norwalk, CA
  • NPI 1689628240

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1275148272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N BRAND BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N BRAND BLVD STE 105",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033991",
            "telephone_number": "818-422-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "PAYLEVANYAN",
        "authorized_official_first_name": "VARDGES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-422-2422"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Hatamian
• Robert Tadashi Hatanaka, DPM
• Jennifer Nicole Hathwell
• Have Faith Home Health Service
• Have Faith Hospice Services Inc
• Gary Jordan Havens, M.D.
• Richard Hratchia Havunjian, M.D.
• Michelle Hawkins, D.C.
• Fabio Issamu Hayabe, RN
• David Hayashi

• Community Based Hospice Care Agency in Glendale, CA
• Providers in Glendale, 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 15, 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.