Bona Fide Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BONA FIDE HOSPICE INC

Practice address

14529 Archwood St Ste 106
Van Nuys, CA 91405-4602

Phone

(747) 466-6313

NPI assigned

Jun 15, 2020

Organization subpart

No

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

Authorized official

Name

Eduard Aivazovi

Title

Ceo

Phone

(747) 466-6313

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B21708

Legal name

BONA FIDE HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 17, 2021

Last certification

Aug 17, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jan 6, 2020 in CA

Enrollment address

5315 Laurel Canyon Blvd
Ste 201
Valley Village, CA 91607-4916

Listed as

Bona Fide Hospice, IncCCN B21708

Ownership

For-Profit

Certified

Aug 17, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 3

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

Practitioners 2

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

• Afsaneh Yocheved Balakhaneh, LCSW

  • Counselor
  • North Hollywood, CA
  • NPI 1962998104
  NPD (past)
• Brianna Rose Statman, LMFT

  • Marriage & Family Therapist
  • Valley Village, CA
  • NPI 1447880059
  NPD (past)

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1407471535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14529 ARCHWOOD ST STE 106",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054602",
            "telephone_number": "747-466-6313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14529 ARCHWOOD ST STE 106",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054602",
            "telephone_number": "747-466-6313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONA FIDE HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "AIVAZOVI",
        "authorized_official_first_name": "EDUARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-466-6313"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nubar Boghossian, M.D.
• Trinaya Krishnan Bokam
• Heather Bolewski
• Devon Alexander Bolton
• Jason Lee Bolton, PSY.D.
• Bona Vita Hospice, Inc.
• Stephanie Bond
• Carrie Bonfitto, NC
• Alexandra Bonilla
• Jose Bonilla

• 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 Mar 14, 2025; 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.