Organization Active NPI

Saunders Hospice,LLC

  • Community Based Hospice Care Agency
  • Northridge, CA
National Provider Identifier
1780090647
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SAUNDERS HOSPICE,LLC
Practice address
9017 Reseda Blvd
# 209
Northridge, CA 91324-3922
Phone
(818) 669-7609
NPI assigned
Jul 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Authorized official

Name
Miss Carmen Corder
Title
Contact Person
Phone
(323) 828-5658

Specialties & licenses 1

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

Addresses

Primary practice location

9017 Reseda Blvd
# 209
Northridge, CA 91324-3922

Mailing address

9017 Reseda Blvd
# 209
Northridge, CA 91324-3922
Phone (818) 669-7609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181228001156 CA Part A Provider - Hospice 2860737574 Practice locations: Northridge, CA

Hospice certification: CCN B51628

Legal name
SAUNDERS HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 14, 2022
Last certification
Nov 17, 2022
Organization structure
LLCProprietary
Incorporated
May 15, 2014 in CA
Enrollment address
9017 Reseda Blvd
Ste 209
Northridge, CA 91324-3981

Care Compare: Hospice

Medicare Care Compare
Listed as
Saunders Hospice, LLCCCN B51628
Certified
Dec 14, 2022
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
05D2102200Saunders Hospice LLC9017 Reseda Blvd Ste 209, Northridge, CA 91324Certificate of waiverAug 14, 2027

National Provider Directory

National Provider Directory

Locations

9017 Reseda Blvd
Ste 209
Northridge, CA 91324
Phone (818) 669-7609

171 N Altadena Dr
Ste 220
Pasadena, CA 91107
Phone (626) 765-6399

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Anaid Matinyan Individual W-2 Managing EmployeeAd; Mar 1, 2024
Gemma D Labastida Individual Corporate OfficerBoard Member Nov 6, 2018 100%
W-2 Managing EmployeeAdministrator/Director of Patien Nov 6, 2018 100%
Operational/Managerial ControlAdministrator/Director of Patien Nov 6, 2018 100%
Jeffrey Shukhman Individual Contracted Managing EmployeeMD; Dec 1, 2023
Arbin Davtyan Individual 5% Or Greater Direct Ownership Interest Mar 1, 2021 50%
Corporate OfficerCeo/President/Secretary/Boardmbr Mar 1, 2021 50%
Corporate DirectorCeo/President/Secretary/Boardmbr Mar 1, 2021 50%
W-2 Managing EmployeeCeo/President/Secretary/Boardmbr Mar 1, 2021 50%
Arman Akopian Individual 5% Or Greater Direct Ownership Interest Mar 1, 2021 50%
Corporate OfficerCfo/Member of Board/50% Owner Mar 1, 2021 50%
Corporate DirectorCfo/Member of Board/50% Owner Mar 1, 2021 50%
W-2 Managing EmployeeCfo/Member of Board/50% Owner Mar 1, 2021 50%

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404950400000",
    "number": "1780090647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9017 RESEDA BLVD",
            "address_2": "# 209",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243922",
            "telephone_number": "818-669-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9017 RESEDA BLVD",
            "address_2": "# 209",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243922",
            "telephone_number": "818-669-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAUNDERS HOSPICE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A",
        "authorized_official_last_name": "CORDER",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CONTACT PERSON",
        "authorized_official_telephone_number": "323-828-5658",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.