Organization Active NPI

Elevate Hospice Care Inc

  • Community Based Hospice Care Agency
  • Van Nuys, CA
National Provider Identifier
1861004673
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ELEVATE HOSPICE CARE INC
Practice address
14545 Friar St Ste 139
Van Nuys, CA 91411-2397
Phone
(818) 850-2151
Fax
(818) 960-0143
NPI assigned
Aug 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Authorized official

Name
Armen Way Avetisyan
Title
Ceo
Phone
(818) 850-2151

Specialties & licenses 1

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

Addresses

Primary practice location

14545 Friar St Ste 139
Van Nuys, CA 91411-2397

Mailing address

14545 Friar St Ste 139
Van Nuys, CA 91411-2397
Phone (818) 850-2151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201028002975 CA Part A Provider - Hospice 7012327208 Practice locations: Van Nuys, CA

Hospice certification: CCN D61523

Legal name
ELEVATE HOSPICE CARE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 6, 2024
Last certification
Mar 28, 2024
Organization structure
CorporationProprietary
Incorporated
Jul 7, 2020 in CA
Enrollment address
14545 Friar St
Ste 139
Van Nuys, CA 91411-2397

Care Compare: Hospice

Medicare Care Compare
Listed as
Elevate Hospice Care, Inc.CCN D61523
Certified
May 6, 2024
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

14545 Friar St
Ste 139
Van Nuys, CA 91411
Phone (818) 850-2151

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Armen Way Avetisyan Individual 5% Or Greater Direct Ownership InterestCeo/Cfo/Secretary Jul 7, 2020 100%
Corporate OfficerCeo/Cfo/Secretary Jul 7, 2020 100%
Corporate DirectorCeo Jul 7, 2020 100%
W-2 Managing EmployeeCeo/Cfo/Secretary Jul 7, 2020 100%
Operational/Managerial ControlCeo/Cfo/Secreary Jul 7, 2020 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1597968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1861004673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 139",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112397",
            "telephone_number": "818-850-2151",
            "fax_number": "818-960-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 139",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112397",
            "telephone_number": "818-850-2151",
            "fax_number": "818-960-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-21",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "AVETISYAN",
        "authorized_official_first_name": "ARMEN",
        "authorized_official_middle_name": "WAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-850-2151"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.