NPIMap

Organization Active NPI

Sycamore Grove Healthcare LLC

  • Community Based Hospice Care Agency
  • Delano, CA
National Provider Identifier
1609504497
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SYCAMORE GROVE HEALTHCARE LLC
Practice address
601 High St Unit E
Delano, CA 93215-2969
Phone
(661) 244-8126
NPI assigned
Aug 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Authorized official

Name
Amber Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

601 High St Unit E
Delano, CA 93215-2969

Mailing address

601 High St Unit E
Delano, CA 93215-2969
Phone (661) 244-8126

Other names 1

  • Ardent Hospice of the Valley Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220921000787 CA Part A Provider - Hospice 9537544531 Practice locations: Delano, CA

Hospice certification: CCN A01585

Legal name
SYCAMORE GROVE HEALTHCARE LLC
Doing business as
ARDENT HOSPICE OF THE VALLEY
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 1, 2019
Last certification
Apr 1, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
601 High St
Unit E
Delano, CA 93215-2969

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Ardent Hospice of the ValleyCCN A01585
Ownership
For-Profit
Certified
Apr 1, 2019
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2132181Sycamore Grove Healthcare LLC601 High Street, Ste E, Delano, CA 93215Certificate of waiverJun 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ardent Home Health of Fresno3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2040 N Winery Ave
Ste 102
Fresno, CA 93703
Phone (559) 408-5945

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 16, 2022 100%
Jacob McKenzie Individual W-2 Managing EmployeeAd;Executive Director Jun 9, 2026
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Brent Guerisoli Individual Corporate DirectorDirector and Sole Board Member Aug 1, 2022
Alyssa Effisimo Individual W-2 Managing EmployeeDPCS Designee Feb 10, 2026
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 16, 2022 100%
Brent Alan Wilson Individual W-2 Managing EmployeeMD; Aug 16, 2022
Abner C Villarreal Individual W-2 Managing EmployeeAd;Designee & DPCS Jun 9, 2026
John J Gochnour Individual Corporate OfficerPresident / LLC Manager Apr 10, 2024
Amber Tueller Individual Corporate OfficerSecretary Apr 10, 2024
Elliot McMillan Individual Corporate OfficerVice President Apr 10, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

Change-of-ownership history 1

DateEventCounterparty
Aug 16, 2022 Change of OwnershipThis provider was the buyer Ardent Hospice of the ValleyCCN A01585, CA, NPI 1790226827

Change of ownership 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746403200000",
    "number": "1609504497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HIGH ST UNIT E",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932152969",
            "telephone_number": "661-244-8126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HIGH ST UNIT E",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932152969",
            "telephone_number": "661-244-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYCAMORE GROVE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-10",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ardent Hospice of the Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ardent Hospice of the Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delano, CA

Sources for this page

Verify at the official NPI Registry.