Organization Active NPI

Community Care Hospice,Inc.

  • Community Based Hospice Care Agency
  • Van Nuys, CA
National Provider Identifier
1285192690
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
COMMUNITY CARE HOSPICE,INC.
Practice address
13629 1/2 Victory Blvd.
Van Nuys, CA 91401
Phone
(818) 616-4956
Fax
(818) 908-9099
NPI assigned
Mar 5, 2019
Last updated
Mar 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Authorized official

Name
Ms. Zara Nalbandyan
Title
Ceo
Phone
(818) 616-4956

Specialties & licenses 1

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

Addresses

Primary practice location

13629 1/2 Victory Blvd.
Van Nuys, CA 91401

Mailing address

13629 1/2 Victory Blvd.
Van Nuys, CA 91401
Phone (818) 616-4956

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200504001301 CA Part A Provider - Hospice 8123459377 Practice locations: Van Nuys, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285192690. Details of each certification follow.

Hospice certification: CCN B21579

Legal name
COMMUNITY CARE HOSPICE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 20, 2021
Last certification
Feb 20, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Aug 21, 2018 in CA
Enrollment address
13629 1/2 Victory Blvd
Van Nuys, CA 91401-1735

Care Compare: Hospice

Medicare Care Compare
Listed as
Community Care Hospice, IncCCN B21579 · All quality measures
Ownership
For-Profit
Certified
Feb 20, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

13629 Victory Blvd
Van Nuys, CA 91401
Phone (818) 616-4956

Ownership & related parties

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.

NameRoleSinceShare
Luz Tabajonda Individual W-2 Managing EmployeeDPCS/Administrator Aug 21, 2018
Zara Nalbandyan Individual 5% Or Greater Direct Ownership Interest Aug 21, 2018 100%
Corporate OfficerCeo/Cfo/Secretary/Owner Aug 21, 2018 100%
Corporate DirectorCeo/Cfo/Secretary/Owner Aug 21, 2018 100%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551744000000",
    "number": "1285192690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13629 1/2 VICTORY BLVD.",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91401",
            "telephone_number": "818-616-4956",
            "fax_number": "818-908-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13629 1/2 VICTORY BLVD.",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91401",
            "telephone_number": "818-616-4956",
            "fax_number": "818-908-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE HOSPICE,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-03-05",
        "status": "A",
        "authorized_official_last_name": "NALBANDYAN",
        "authorized_official_first_name": "ZARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-616-4956",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.