Good Life Palliative Care

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

GOOD LIFE PALLIATIVE CARE

Practice address

20953 Devonshire St Ste 8a
Chatsworth, CA 91311-2371

Phone

(310) 877-8067

NPI assigned

May 13, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Hollis Frederick

Title

Ceo/Administrator

Phone

(310) 877-8067

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN A11711

Legal name

GOOD LIFE PALLIATIVE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 26, 2021

Last certification

Jan 26, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 3, 2019 in CA

Enrollment address

20953 Devonshire St
Ste 8a
Chatsworth, CA 91311-2371

Listed as

Good Life Palliative CareCCN A11711

Ownership

For-Profit

Certified

Jan 26, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1801452180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20953 DEVONSHIRE ST STE 8A",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112371",
            "telephone_number": "310-877-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20953 DEVONSHIRE ST STE 8A",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112371",
            "telephone_number": "310-877-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LIFE PALLIATIVE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "HOLLIS",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "310-877-8067",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Years Hospice Services, Inc
• Goldstar Healthcare Center of Chatsworth, Inc.
• Pegah Golpanian, PHARMD
• Ivan Alberto Gonzalez
• Jocelyn Karina Gonzalez
• Eric Jeffrey Gorinstein, M.D.
• Ross David Gould, D.C., QME
• Elena Grajeda
• Cheryl Vanessa Gray, MD
• Siranush Grigorian

• Community Based Hospice Care Agency in Chatsworth, CA
• Providers in Chatsworth, 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 Jan 2, 2020; 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.