Sand and Sage Personal Care Agency

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SAND AND SAGE PERSONAL CARE AGENCY

Practice address

121 W Beech St
Lamar, CO 81052-2731

Phone

(719) 688-9666

Fax

(719) 691-2132

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Jacqueline Rae HinerNPI 1740887405

Title

Owner/Manager

Phone

(719) 688-9666

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Jacqueline Rae Hiner

  • In Home Supportive Care Agency
  • Lamar, CO
  • NPI 1740887405

  In Home Supportive Care

  NPD Authorized official

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1740650431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WEST ELM STREET",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "81052",
            "telephone_number": "719-688-9666",
            "fax_number": "719-691-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W BEECH ST",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810522731",
            "telephone_number": "719-688-9666",
            "fax_number": "719-691-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAND AND SAGE PERSONAL CARE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "HINER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "719-688-9666"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CO",
            "license": "04S685",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30854369",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kari Sheree Roth, RDH
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• Andrew J Saueracker, M.D.
• Andrea Schultz, M.S.
• Barbara Schutzenhofer, CRNA
• Carleta Schwartz, M.A.
• Dionysius Semien

• All providers in Lamar, CO
• In Home Supportive Care Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.