Organization Active NPI

Highland Hospice, Inc.

  • Community Based Hospice Care Agency
  • Glendale, CA
National Provider Identifier
1992343651
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HIGHLAND HOSPICE, INC.
Practice address
1415 E Colorado St Ste 207
Glendale, CA 91205-1541
Phone
(818) 962-8489
Fax
(818) 665-3199
NPI assigned
Dec 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Authorized official

Name
Aram Abramian
Title
Ceo
Phone
(818) 962-8489

Specialties & licenses 1

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

Addresses

Primary practice location

1415 E Colorado St Ste 207
Glendale, CA 91205-1541

Mailing address

1415 E Colorado St Ste 207
Glendale, CA 91205-1541
Phone (818) 962-8489

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200609003089 CA Part A Provider - Hospice 2961823455 Practice locations: Chatsworth, CA

Hospice certification: CCN A11767

Legal name
HIGHLAND HOSPICE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 19, 2021
Last certification
Jan 19, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Oct 29, 2019 in CA
Enrollment address
21220 Devonshire St
Ste 211
Chatsworth, CA 91311-8260

Care Compare: Hospice

Medicare Care Compare
Listed as
Highland Hospice, IncCCN A11767 · All quality measures
Ownership
For-Profit
Certified
Jan 19, 2021
Medicare certification status
ActiveFrom the Provider of Services file

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
05D2297221Highland Hospice Inc21220 Devonshire St Ste 211, Chatsworth, CA 91311Certificate of waiverJan 10, 2028

National Provider Directory

National Provider Directory

Locations

21220 Devonshire St
Ste 211
Chatsworth, CA 91311
Phone (818) 962-8489

1415 E Colorado St
Ste 207
Glendale, CA 91205
Phone (818) 935-6140

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Siamak P Etehad Individual Contracted Managing EmployeeMD; Apr 1, 2024
Abygail Go Individual 5% Or Greater Direct Ownership InterestCeo Aug 25, 2022 100%
Corporate OfficerCeo Aug 25, 2022 100%
Corporate DirectorCeo Aug 25, 2022 100%
W-2 Managing EmployeeAd;Ceo Aug 25, 2022 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

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": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1992343651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 E COLORADO ST STE 207",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051541",
            "telephone_number": "818-962-8489",
            "fax_number": "818-665-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E COLORADO ST STE 207",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051541",
            "telephone_number": "818-962-8489",
            "fax_number": "818-665-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "ABRAMIAN",
        "authorized_official_first_name": "ARAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-962-8489"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.