Sacred Heart Home Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HHA5140 Issued in AZ

Legal business name

SACRED HEART HOME HEALTHCARE LLC

Practice address

2737 E Greenway Rd Ste 6
Phoenix, AZ 85032-4391

Phone

(602) 795-0739

NPI assigned

Jul 11, 2017

Organization subpart

No

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

Authorized official

Name

Bob Blevins

Title

Ceo

Phone

(602) 795-0739

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Rock Garden Healthcare LLC

  • Home Health Agency
  • Phoenix, AZ
  • NPI 1033715222

  Sold to, 2021-01-16

  CMS change of ownership

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1497277545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 78TH ST STE 202",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661122406",
            "telephone_number": "913-244-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 E GREENWAY RD STE 6",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324391",
            "telephone_number": "602-795-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART HOME HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-11",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "BLEVINS",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-795-0739"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "HHA5140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03-7438",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chasby A Sacks, M.D.
• Paul Sacks, M.D.
• Rivi Rose Sacks
• Kimberly E Sacra, LPC
• Sacred Heart Foundation, Inc
• Sacred Heart Homes, Inc
• Sacred Heart Homes, Inc.
• Sacred Heart Hospice LLC
• Sacred Heart Nursing
• Sacred Heart Nursing Services, Inc.

• Home Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Home Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.