Active NPI
La Elder Hospice and Palliative Care, Inc.
- Community Based Hospice Care Agency
- Van Nuys, CA
National Provider Identifier
1699382671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- LA ELDER HOSPICE AND PALLIATIVE CARE, INC.
- Practice address
- 6454 Van Nuys Blvd Ste 1108
Van Nuys, CA 91401-1445 - Phone
- (747) 251-4006
- NPI assigned
- Sep 24, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hieldeen H Bonsall
- Title
- Ceo
- Phone
- (747) 251-4006
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
6454 Van Nuys Blvd Ste 1108
Van Nuys, CA 91401-1445
Mailing address
6454 Van Nuys Blvd Ste 1108
Van Nuys, CA 91401-1445
Phone (747) 251-4006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210804000985 | CA | Part A Provider - Hospice | 0446654040 | Practice locations: Van Nuys, CA |
Hospice certification: CCN B31570
- Legal name
- LA ELDER HOSPICE AND PALLIATIVE CARE INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Dec 1, 2021
- Last certification
- Dec 1, 2021
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Aug 18, 2020 in CA
- Enrollment address
- 6454 Van Nuys Blvd
Ste 110/8
Van Nuys, CA 91401-1445
Care Compare: Hospice
Medicare Care Compare- Listed as
- La Elder Hospice and Palliative Care, Inc
- Certified
- Dec 1, 2021
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
6454 Van Nuys Blvd
Ste 1108
Van Nuys, CA 91401
Phone (747) 251-4006
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Luningning B Hernandez | 5% Or Greater Direct Ownership Interest | Oct 25, 2022 | 50% |
| Corporate Officer | Oct 25, 2022 | 50% | |
| Corporate Director | Oct 25, 2022 | 50% | |
| W-2 Managing Employee | Oct 25, 2022 | 50% | |
| Hieldeen H Huerta | 5% Or Greater Direct Ownership Interest | Oct 25, 2022 | 50% |
| Corporate Officer | Oct 25, 2022 | 50% | |
| Corporate Director | Oct 25, 2022 | 50% | |
| W-2 Managing Employee | Oct 25, 2022 | 50% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600905600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1673827200000",
"number": "1699382671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6454 VAN NUYS BLVD STE 1108",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914011445",
"telephone_number": "747-251-4006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6454 VAN NUYS BLVD STE 1108",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914011445",
"telephone_number": "747-251-4006"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LA ELDER HOSPICE AND PALLIATIVE CARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2020-09-24",
"last_updated": "2023-01-16",
"certification_date": "2023-01-16",
"status": "A",
"authorized_official_last_name": "BONSALL",
"authorized_official_first_name": "HIELDEEN",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "747-251-4006"
},
"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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.