Sky Harbor Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SKY HARBOR HOSPICE, INC.

Practice address

808 Bidwell St Ste D
Folsom, CA 95630-3041

Phone

(818) 660-9109

NPI assigned

Jul 12, 2021

Last updated

Jul 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lusine Revazyan

Title

Ceo/Owner

Phone

(818) 660-9109

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1275105066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 BIDWELL ST STE D",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303041",
            "telephone_number": "818-660-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 BIDWELL ST STE D",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303041",
            "telephone_number": "818-660-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKY HARBOR HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "REVAZYAN",
        "authorized_official_first_name": "LUSINE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "818-660-9109"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Folsom, CA
• Providers in Folsom, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.