Ets Hospice Care, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ETS HOSPICE CARE, INC.

Practice address

6410 Van Nuys Blvd Ste F202
Van Nuys, CA 91401-6263

Phone

(747) 282-0407

NPI assigned

Nov 17, 2020

Organization subpart

No

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

Authorized official

Name

Vagharshak Grigoryan

Title

Ceo

Phone

(747) 282-0407

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B51763

Legal name

ETS HOSPICE CARE, INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 7, 2023

Last certification

Jun 7, 2023

Organization structure

CorporationProprietary

Enrollment address

1207 W Magnolia Blvd
Suite D
Burbank, CA 91506-1863

Listed as

Ets Hospice Care, IncCCN B51763 · All quality measures

Certified

Jun 7, 2023

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.

Owners & managing parties with NPI records 1

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

• Hani Adiep Benyamin-Ajaipi

  • Internal Medicine Physician
  • Los Alamitos, CA
  • NPI 1770783896

  Contracted Managing Employee

  CMS ownership

Practitioners 1

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

• Hani Adiep Benyamin-Ajaipi

  • Internal Medicine Physician
  • Los Alamitos, CA
  • NPI 1770783896
  NPD (past)

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1316540917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 VAN NUYS BLVD STE F202",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914016263",
            "telephone_number": "747-282-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 VAN NUYS BLVD STE F202",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914016263",
            "telephone_number": "747-282-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETS HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "GRIGORYAN",
        "authorized_official_first_name": "VAGHARSHAK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-282-0407"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tricia Eustache, MA, CCC-SLP
• Kimberly Evans, B. A. FINE ARTS
• Linda Evans
• Michelle L Evans
• Tyler Nicole Evans, BA,MA,PPS

• Community Based Hospice Care Agency in Van Nuys, CA
• Providers in Van Nuys, 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 Nov 17, 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.