Moon and Back Hospice Care, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MOON AND BACK HOSPICE CARE, INC.

Practice address

2828 Mills Park Dr Ste F
Rancho Cordova, CA 95670-4711

Phone

(916) 777-0018

NPI assigned

Apr 29, 2021

Organization subpart

No

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

Authorized official

Name

Artavazd Gevorgyan

Title

Ceo

Phone

(916) 777-0018

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1417530395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 MILLS PARK DR STE F",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956704711",
            "telephone_number": "916-777-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 MILLS PARK DR STE F",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956704711",
            "telephone_number": "916-777-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON AND BACK HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "GEVORGYAN",
        "authorized_official_first_name": "ARTAVAZD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-777-0018"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.