Organization Active NPI

Sanctuary Home Health

  • Home Health Agency
  • Sacramento, CA
National Provider Identifier
1184285041
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Dec 2, 2024

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationProprietary
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 HealthCCN 757114 · All quality measures
Overall star rating
4.5 of 5
Ownership
-
Certified
Jan 21, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Scott J Meyers Individual Corporate Director Jan 12, 2022
Robert E Tucker Individual Corporate Director Jan 12, 2022
Courtney E Pike Individual 5% Or Greater Direct Ownership InterestChief Operating Officer Dec 31, 2021 10%
Corporate OfficerChief Operating Officer Jan 12, 2022
Corporate DirectorChief Operating Officer Jan 12, 2022
W-2 Managing EmployeeChief Operating Officer Dec 31, 2021
Operational/Managerial ControlChief Operating Officer Dec 31, 2021
Sandra Kumiko Tucker Individual 5% Or Greater Direct Ownership InterestAdministrator & President/Cfo Dec 31, 2021 51%
Corporate OfficerAdministrator & President/Cfo Jan 12, 2022
Corporate DirectorAdministrator & President/Cfo Jan 12, 2022
W-2 Managing EmployeeAdministrator & President/Cfo Dec 31, 2021
Operational/Managerial ControlAdministrator & President/Cfo Dec 31, 2021
Angela Lee Macadangdang Individual 5% Or Greater Direct Ownership InterestSecretary/Cco Dec 31, 2021 39%
Corporate OfficerSecretary/Cco Jan 12, 2022
Corporate DirectorSecretary/Cco Jan 12, 2022
W-2 Managing EmployeeSecretary/Cco Dec 31, 2021
Operational/Managerial ControlSecretary/Cco Dec 31, 2021

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "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

Verify at the official NPI Registry.