Organization Active NPI

Woodland Hospice Care Inc

  • Community Based Hospice Care Agency
  • Woodland Hills, CA
National Provider Identifier
1881276509
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
WOODLAND HOSPICE CARE INC
Practice address
8925 Sepulveda Blvd Suite 260
Woodland Hills, CA 91364
Phone
(818) 805-3042
NPI assigned
Apr 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Lilit Khachatryan
Title
Ceo
Phone
(818) 805-3042

Specialties & licenses 1

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

Addresses

Primary practice location

8925 Sepulveda Blvd Suite 260
Woodland Hills, CA 91364

Mailing address

8925 Sepulveda Blvd Suite 260
Woodland Hills, CA 91364
Phone (818) 805-3042

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220103000189 CA Part A Provider - Hospice 3577954494 Practice locations: Woodland Hills, CA

Hospice certification: CCN B41778

Legal name
WOODLAND HOSPICE CARE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 22, 2022
Last certification
Jun 22, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Dec 18, 2020 in CA
Enrollment address
21241 Ventura Blvd
Ste 260
Woodland Hills, CA 91364-2186

Care Compare: Hospice

Medicare Care Compare
Listed as
Woodland Hospice Care, IncCCN B41778 ยท All quality measures
Certified
Jun 22, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

21241 Ventura Blvd
Ste 260
Woodland Hills, CA 91364
Phone (818) 605-1944

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
Irbeg Z Dzutsev Individual 5% Or Greater Direct Ownership Interest May 3, 2023 100%
Corporate OfficerCeo May 3, 2023
Corporate DirectorCeo May 3, 2023
W-2 Managing EmployeeCeo May 3, 2023
Operational/Managerial ControlCeo May 3, 2023

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": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1881276509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8925 SEPULVEDA BLVD SUITE 260",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "91364",
            "telephone_number": "818-805-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8925 SEPULVEDA BLVD SUITE 260",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "91364",
            "telephone_number": "818-805-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "KHACHATRYAN",
        "authorized_official_first_name": "LILIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-805-3042"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.