PSL Hospice Care, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PSL HOSPICE CARE, INC

Practice address

520 E Wilson Ave Ste 230
Glendale, CA 91206-4396

Phone

(818) 305-6561

NPI assigned

Apr 15, 2020

Last updated

May 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Boris Antonyan

Title

Ceo

Phone

(818) 305-6561

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386263622. Details of each certification follow.

• CCN B21687 Hospice · Active · Details

Hospice certification: CCN B21687

Legal name

PSL HOSPICE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 4, 2021

Last certification

Aug 4, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 17, 2019 in CA

Enrollment address

14545 Friar St
Ste 202U
Van Nuys, CA 91411-2398

Listed as

PSL Hospice Care, IncCCN B21687 · All quality measures

Ownership

For-Profit

Certified

Aug 4, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1386263622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E WILSON AVE STE 230",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064396",
            "telephone_number": "818-305-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E WILSON AVE STE 230",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064396",
            "telephone_number": "818-305-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSL HOSPICE CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-15",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "ANTONYAN",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-305-6561"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 May 13, 2024; 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.