NPIMap

Organization Active NPI

The Care Center on Hazeltine LLC

  • Skilled Nursing Facility
  • Van Nuys, CA
National Provider Identifier
1831752377
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE CARE CENTER ON HAZELTINE LLC
Practice address
6835 Hazeltine Ave
Van Nuys, CA 91405-3218
Phone
(818) 997-1841
Fax
(818) 997-1844
NPI assigned
Apr 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Authorized official

Name
Jose Lynch
Title
Manager
Phone
(714) 673-6899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

6835 Hazeltine Ave
Van Nuys, CA 91405-3218

Mailing address

400 Exchange Ste 140
Irvine, CA 92602-1343

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190430000004 CA Part A Provider - Skilled Nursing Facility 1254673957 Practice locations: Van Nuys, CA

Skilled nursing facility certification: CCN 555519

Legal name
THE CARE CENTER ON HAZELTINE, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 16, 1992
Last certification
Nov 7, 2024
Beds
58
Ownership / control type
Partnership
Organization structure
LLCProprietary
Incorporated
Feb 21, 2019 in CA
Enrollment address
6835 Hazeltine Ave
Van Nuys, CA 91405-3218
Nursing home name
THE CARE CENTER ON HAZELTINE, LLC

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Care Center on Hazeltine, LLCCCN 555519
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Sep 16, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5848.3 residents per day on average
Penalties (3 years)
4Fines totaling $72,521

Processed by Care Compare on Aug 1, 2026.

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
05D0642826Care Center on Hazeltine LLC6835 Hazeltine Ave, Van Nuys, CA 91405Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Abby GL LLC Organization, Irvine, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 7, 2019 92%
Eretz Van Nuys Properties LLC Organization, Irvine, CA LLC Adp of the SNF Mar 7, 2019
Jose C Lynch Individual 5% Or Greater Indirect Ownership InterestManaging Member of Abby GL LLC Feb 21, 2019 92%
Operational/Managerial ControlManaging Member Feb 21, 2019 92%
Ellie LLC Organization, Reseda, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 21, 2019 6%
Julio C Cruz Individual 5% Or Greater Indirect Ownership InterestManaging Member of Ellie LLC Feb 21, 2019 6%
John Nelson Valencia Individual Operational/Managerial Control Nov 20, 2020
Adp of the SNF Mar 27, 2025
James E Sims Individual Direct Ownership Interest Feb 21, 2019 2%
Pursue Health LLC Organization, Irvine, CA LLC, Consulting firm Operational/Managerial Control Jan 1, 2021
Adp of the SNF Apr 24, 2025
James Anthony Michail Individual Operational/Managerial Control Aug 15, 2020
Adp of the SNF Mar 27, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1555632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1831752377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EXCHANGE STE 140",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6835 HAZELTINE AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053218",
            "telephone_number": "818-997-1841",
            "fax_number": "818-997-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CARE CENTER ON HAZELTINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-19",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "714-673-6899"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.