Organization Active NPI

Love and Care Hospice Service Inc

  • Community Based Hospice Care Agency
  • Sherman Oaks, CA
National Provider Identifier
1952933558
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LOVE AND CARE HOSPICE SERVICE INC
Practice address
5658 Sepulveda Blvd Ste 214
Sherman Oaks, CA 91411-2951
Phone
(818) 849-6226
NPI assigned
Feb 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Valeriya Rybalko
Title
President
Phone
(310) 801-4112

Specialties & licenses 1

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

Addresses

Primary practice location

5658 Sepulveda Blvd Ste 214
Sherman Oaks, CA 91411-2951

Mailing address

5868 Sepulveda Blvd #214
Sherman Oaks, CA 91411
Phone (818) 849-6226

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201001002730 CA Part A Provider - Hospice 7012336571 Practice locations: Sherman Oaks, CA

Hospice certification: CCN B21623

Legal name
LOVE AND CARE HOSPICE SERVICE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 12, 2021
Last certification
Mar 12, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jul 3, 2019 in CA
Enrollment address
5658 Sepulveda Blvd
Ste 214
Sherman Oaks, CA 91411-2951

Care Compare: Hospice

Medicare Care Compare
Listed as
Love and Care Hospice Service IncCCN B21623
Ownership
For-Profit
Certified
Mar 12, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

5868 Sepulveda Blvd 214
Sherman Oaks, CA 91411

5658 Sepulveda Blvd
Ste 214
Van Nuys, CA 91411
Phone (818) 849-6226

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Josephine Crisostomo Individual 5% Or Greater Direct Ownership InterestCeo Mar 15, 2022 33.33%
Corporate OfficerCeo Mar 15, 2022 33.33%
Corporate DirectorCeo Mar 15, 2022 33.33%
W-2 Managing EmployeeAd; Mar 15, 2022 33.33%
Aiko Ono Individual 5% Or Greater Direct Ownership Interest Aug 11, 2022 33.33%
Corporate Director Aug 11, 2022 33.33%
Alta Fe Garcia Nalitan Individual 5% Or Greater Direct Ownership InterestSecretary Mar 15, 2022 33.34%
Corporate OfficerSecretary Mar 15, 2022 33.34%
Corporate DirectorSecretary Mar 15, 2022 33.34%

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": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1952933558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5868 SEPULVEDA BLVD #214",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "91411",
            "telephone_number": "818-849-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5658 SEPULVEDA BLVD STE 214",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914112951",
            "telephone_number": "818-849-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVE AND CARE HOSPICE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "RYBALKO",
        "authorized_official_first_name": "VALERIYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-801-4112"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.