Active NPI
Citadel & Ivan LLC
- Community Based Hospice Care Agency
- Fresno, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- CITADEL & IVAN LLC
- Practice address
- 5100 N 6TH St
Suite150
Fresno, CA 93710-7514 - Phone
- (559) 227-7202
- Fax
- (559) 227-7203
- NPI assigned
- Dec 1, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Citadel Chavez
- Title
- Ceo
- Phone
- (559) 355-8956
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
5100 N 6TH St
Suite150
Fresno, CA 93710-7514
Mailing address
5100 N 6TH St
Suite150
Fresno, CA 93710-7514
Phone (559) 227-7202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170918000114 | CA | Part A Provider - Hospice | 6507130473 | Practice locations: Fresno, CA |
Hospice certification: CCN A01537
- Legal name
- CITADEL & IVAN LLC
- Doing business as
- HOSPICE OF THE VALLEY
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Nov 2, 2018
- Last certification
- Mar 15, 2022
- Ownership / control type
- Proprietary - Individual
- Organization structure
- LLC
- Incorporated
- in CA
- Enrollment address
- 5100 N 6TH St
Ste 150
Fresno, CA 93710-7515
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Care Compare: Hospice
Medicare Care Compare- Listed as
- Hospice of the Valley
- Ownership
- For-Profit
- Certified
- Nov 2, 2018
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Citadel Ivan LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Fresno, CA
- NPI 1730714171
Locations
5100 N 6th St
Ste 150
Fresno, CA 93710
Phone (559) 227-7202
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Leticia Luna | W-2 Managing Employee | Aug 16, 2016 | |
| Ara Soghomonian | Corporate Director | Aug 16, 2016 | |
| Citadel M Chavez | 5% Or Greater Direct Ownership Interest | Aug 15, 2016 | 100% |
| W-2 Managing Employee | Aug 16, 2016 | 100% | |
| Operational/Managerial Control | Aug 15, 2016 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Home Health Agency
- Fresno, CA
- NPI 1154806545
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": "1480550400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1480550400000",
"number": "1982147492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 N 6TH ST",
"address_2": "SUITE150",
"city": "FRESNO",
"state": "CA",
"postal_code": "937107514",
"telephone_number": "559-227-7202",
"fax_number": "559-227-7203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 N 6TH ST",
"address_2": "SUITE150",
"city": "FRESNO",
"state": "CA",
"postal_code": "937107514",
"telephone_number": "559-227-7202",
"fax_number": "559-227-7203"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITADEL & IVAN LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-12-01",
"last_updated": "2016-12-01",
"status": "A",
"authorized_official_last_name": "CHAVEZ",
"authorized_official_first_name": "CITADEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "559-355-8956",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.