Active NPI
Aloe Vera Hospice LLC
- Registered Nurse
- Tarzana, CA
National Provider Identifier
1750908109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- Legal business name
- ALOE VERA HOSPICE LLC
- Practice address
- 18345 Ventura Blvd Ste 206
Tarzana, CA 91356-4241 - Phone
- (818) 869-9569
- NPI assigned
- Jul 1, 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
- Hakob Naskhulyan
- Title
- Cfo
- Phone
- (818) 940-4409
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | Primary |
Addresses
Primary practice location
18345 Ventura Blvd Ste 206
Tarzana, CA 91356-4241
Mailing address
18713 Stonehaven CT
Porter Ranch, CA 91326-1528
Phone (818) 940-4409
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221017001150 | CA | Part A Provider - Hospice | 1052787058 | Practice locations: Tarzana, CA |
Hospice certification: CCN B51600
- Legal name
- ALOE VERA HOSPICE LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Feb 10, 2023
- Last certification
- Jan 18, 2023
- Organization structure
- LLC
- Incorporated
- Mar 11, 2020 in CA
- Enrollment address
- 18345 Ventura Blvd
Ste 206
Tarzana, CA 91356-4241
Care Compare: Hospice
Medicare Care Compare- Listed as
- Aloe Vera Hospice, Inc.
- Certified
- Feb 10, 2023
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
18345 Ventura Blvd
Ste 206
Tarzana, CA 91356
Phone (818) 869-9569
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 |
|---|---|---|---|
| Astghik Hovhannisyan | 5% Or Greater Direct Ownership Interest | Mar 11, 2020 | 50% |
| Nora Hovhannisyan | 5% Or Greater Direct Ownership Interest | Mar 11, 2020 | 50% |
| W-2 Managing Employee | Mar 11, 2020 | 50% |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Registered Nurse
- Porter Ranch, CA
- NPI 1366334468
Affiliated clinicians 3
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": "1593561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658707200000",
"number": "1750908109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18713 STONEHAVEN CT",
"city": "PORTER RANCH",
"state": "CA",
"postal_code": "913261528",
"telephone_number": "818-940-4409",
"fax_number": "818-699-0588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18345 VENTURA BLVD STE 206",
"city": "TARZANA",
"state": "CA",
"postal_code": "913564241",
"telephone_number": "818-869-9569"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALOE VERA HOSPICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-07-01",
"last_updated": "2022-07-25",
"certification_date": "2022-07-25",
"status": "A",
"authorized_official_last_name": "NASKHULYAN",
"authorized_official_first_name": "HAKOB",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "818-940-4409"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tarzana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.