NPIMap

Organization Active NPI

Health and Life Organization, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
National Provider Identifier
1295044832
Registry record updated Apr 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTH AND LIFE ORGANIZATION, INC.
Practice address
5524 Assembly CT
Sacramento, CA 95823-2625
Phone
(916) 642-1867
NPI assigned
Sep 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2011

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

Authorized official

Name
Mr. Jerry T Bliatout, J.D.
Title
Ceo
Phone
(916) 428-3788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

5524 Assembly CT
Sacramento, CA 95823-2625

Mailing address

7275 E Southgate Dr
Suite 204
Sacramento, CA 95823-2628
Phone (916) 428-3788

Other identifiers 3

IdentifierTypeStateIssuer
1538180245OtherCAUNSPECIFIED
1699082867OtherCANPPES
1740336734OtherCAMEDICARE ID

Other names 1

  • Sacramento Community Clinic - Assembly Court Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110308000291 CA Part B Supplier - Clinic/Group Practice 1153361886 Receives reassigned benefits from 16 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sacramento, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3314 Fong Ranch Rd
Sacramento, CA 95834

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1295044832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7275 E SOUTHGATE DR",
            "address_2": "SUITE 204",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232628",
            "telephone_number": "916-428-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5524 ASSEMBLY CT",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232625",
            "telephone_number": "916-642-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH AND LIFE ORGANIZATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-30",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "BLIATOUT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-428-3788",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNSPECIFIED",
            "identifier": "1538180245",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1699082867",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "1740336734",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacramento Community Clinic - Assembly Court",
            "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 Apr 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.