Emmanuel Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

0002563036-0001-3 Issued in CA

Legal business name

EMMANUEL HOSPICE INC

Practice address

4640 Lankershim Blvd Ste 110
North Hollywood, CA 91602-1848

Phone

(187) 632-7288

Fax

(888) 453-0513

NPI assigned

Jun 22, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Gor Adamyan

Title

Ceo

Phone

(818) 763-2728

Specialties & licenses 1

Addresses

Other names 1

• Hollywood Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 551787

Legal name

EMMANUEL HOSPICE INC

Doing business as

HOLLYWOOD HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 9, 2013

Last certification

Aug 22, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

4640 Lankershim Blvd
Ste 110
North Hollywood, CA 91602-1848

Listed as

Hollywood HospiceCCN 551787

Ownership

For-Profit

Certified

Aug 9, 2013

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Hollywood Health System Inc

  • Home Health Agency
  • North Hollywood, CA
  • NPI 1114996154

  Member Of

  NPD member

Locations

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.

Owners & managing parties with NPI records 2

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

• Hollywood Health System Inc

  • Home Health Agency
  • North Hollywood, CA
  • NPI 1114996154

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Violeta B. Vicencio, MD

  • Internal Medicine Physician
  • Long Beach, CA
  • NPI 1679699193

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Pin-Hung Hsieh, M.D.

  • Internal Medicine Physician
  • Tustin, CA
  • NPI 1144323064

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1831485408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 LANKERSHIM BLVD STE 110",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916021848",
            "telephone_number": "818-763-2728",
            "fax_number": "888-453-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 LANKERSHIM BLVD STE 110",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916021848",
            "telephone_number": "187-632-7288",
            "fax_number": "888-453-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "ADAMYAN",
        "authorized_official_first_name": "GOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-763-2728",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": "0002563036-0001-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hollywood Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Based Hospice Care Agency in North Hollywood, CA
• Providers in North Hollywood, 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 Jul 7, 2021; 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.