Active NPI
Sanctuary Home Health
- Home Health Agency
- Sacramento, CA
National Provider Identifier
1184285041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- SANCTUARY HOME HEALTH
- Doing business as
- Sanctuary Home Health
- Practice address
- 4370 Auburn Blvd Ste B
Sacramento, CA 95841-4107 - Phone
- (916) 903-7107
- Fax
- (916) 903-7134
- NPI assigned
- Jun 21, 2019
- 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
- Sandra K Tucker
- Title
- Administrator & President/Cfo
- Phone
- (916) 903-7107
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
4370 Auburn Blvd Ste B
Sacramento, CA 95841-4107
Mailing address
4370 Auburn Blvd Ste B
Sacramento, CA 95841-4107
Phone (916) 903-7107
Other names 1
- SANCTUARY HOME HEALTH
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220330001512 | CA | Part A Provider - Home Health Agency | 6305267030 | Practice locations: Sacramento, CA |
Home health agency certification: CCN 757114
- Legal name
- SANCTUARY HOME HEALTH
- Doing business as
- SANCTUARY HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jan 21, 2023
- Last certification
- Jan 20, 2023
- Organization structure
- Corporation
- Incorporated
- May 30, 2019 in CA
- Enrollment address
- 4370 Auburn Blvd
Ste B
Sacramento, CA 95841-4107
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Sanctuary Home Health
- Overall star rating
- Ownership
- -
- Certified
- Jan 21, 2023
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
6608 Mercy Ct
Ste D
Fair Oaks, CA 95628
Phone (916) 903-7107
4370 Auburn Blvd
Ste B
Sacramento, CA 95841
Phone (916) 903-7107
Ownership & related parties
All disclosed owners & managing parties 5
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 |
|---|---|---|---|
| Scott J Meyers | Corporate Director | Jan 12, 2022 | |
| Robert E Tucker | Corporate Director | Jan 12, 2022 | |
| Courtney E Pike | 5% Or Greater Direct Ownership Interest | Dec 31, 2021 | 10% |
| Corporate Officer | Jan 12, 2022 | ||
| Corporate Director | Jan 12, 2022 | ||
| W-2 Managing Employee | Dec 31, 2021 | ||
| Operational/Managerial Control | Dec 31, 2021 | ||
| Sandra Kumiko Tucker | 5% Or Greater Direct Ownership Interest | Dec 31, 2021 | 51% |
| Corporate Officer | Jan 12, 2022 | ||
| Corporate Director | Jan 12, 2022 | ||
| W-2 Managing Employee | Dec 31, 2021 | ||
| Operational/Managerial Control | Dec 31, 2021 | ||
| Angela Lee Macadangdang | 5% Or Greater Direct Ownership Interest | Dec 31, 2021 | 39% |
| Corporate Officer | Jan 12, 2022 | ||
| Corporate Director | Jan 12, 2022 | ||
| W-2 Managing Employee | Dec 31, 2021 | ||
| Operational/Managerial Control | Dec 31, 2021 |
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Sacramento, CA
- NPI 1699964700
Home health agency
-
- Orthopaedic Surgery Physician
- Los Angeles, CA
- NPI 1225318876
Home health agency
-
- Internal Medicine Physician
- Folsom, CA
- NPI 1376517656
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561075200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733097600000",
"number": "1184285041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4370 AUBURN BLVD STE B",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958414107",
"telephone_number": "916-903-7107",
"fax_number": "916-903-7134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4370 AUBURN BLVD STE B",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958414107",
"telephone_number": "916-903-7107",
"fax_number": "916-903-7134"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SANCTUARY HOME HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2019-06-21",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A",
"authorized_official_last_name": "TUCKER",
"authorized_official_first_name": "SANDRA",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "ADMINISTRATOR & PRESIDENT/CFO",
"authorized_official_telephone_number": "916-903-7107"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SANCTUARY HOME HEALTH",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.