NPIMap

Organization Active NPI

Maximum Palliative Care and Hospice, Inc.

  • Community Based Hospice Care Agency
  • Lancaster, CA
National Provider Identifier
1467004267
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MAXIMUM PALLIATIVE CARE AND HOSPICE, INC.
Practice address
44501 16TH St W Ste 105
Lancaster, CA 93534-2884
Phone
(661) 495-2051
Fax
(661) 280-2009
NPI assigned
Jul 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Authorized official

Name
Ms. Anna Ilinicna Labutina
Title
Ceo
Phone
(661) 495-2051

Specialties & licenses 1

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

Addresses

Primary practice location

44501 16TH St W Ste 105
Lancaster, CA 93534-2884

Mailing address

44501 16TH St W Ste 105
Lancaster, CA 93534-2884
Phone (661) 495-2051

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200707002841 CA Part A Provider - Hospice 7517380769 Practice locations: Lancaster, CA

Hospice certification: CCN B21523

Legal name
MAXIMUM PALLIATIVE CARE AND HOSPICE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 9, 2020
Last certification
Nov 9, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jul 24, 2018 in CA
Enrollment address
44501 16TH St W
Ste 105
Lancaster, CA 93534-2884

Care Compare: Hospice

Medicare Care Compare
Listed as
Maximum Palliative Care and Hospice, IncCCN B21523
Ownership
For-Profit
Certified
Nov 9, 2020
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2219520Maximum Palliative Care and Hospice Inc44501 16TH St W Ste 105, Lancaster, CA 93534Certificate of waiverApr 5, 2027

National Provider Directory

National Provider Directory

Locations

44501 16th St W
Ste 105
Lancaster, CA 93534
Phone (661) 495-2051

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
Vlad Nusinovich Individual 5% Or Greater Direct Ownership InterestCfo, Secretary Jul 24, 2018 50%
Corporate OfficerCfo/Board Member Jul 24, 2018 50%
Corporate DirectorCfo, Secretary/Board Director Jul 24, 2018 50%
W-2 Managing EmployeeCfo, Secretary Jul 24, 2018 50%
Anna Labutina Individual 5% Or Greater Direct Ownership InterestCeo Jul 24, 2018 50%
Corporate OfficerCeo/Board Member Jul 24, 2018 50%
Corporate DirectorCeo/Board Director Jul 24, 2018 50%
W-2 Managing EmployeeCeo Jul 24, 2018 50%

Owners & managing parties with NPI records 1

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

  • Vlad Nusinovich, M.D.
    • Internal Medicine Physician
    • West Hollywood, CA
    • NPI 1144288036

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1467004267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44501 16TH ST W STE 105",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342884",
            "telephone_number": "661-495-2051",
            "fax_number": "661-280-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44501 16TH ST W STE 105",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342884",
            "telephone_number": "661-495-2051",
            "fax_number": "661-280-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIMUM PALLIATIVE CARE AND HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "LABUTINA",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "ILINICNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "661-495-2051",
        "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 Lancaster, CA

Sources for this page

Verify at the official NPI Registry.