Organization Active NPI

Green Valley Home Health Care & Hospice, Inc.

  • Home Health Agency
  • Roseville, CA
National Provider Identifier
1780966796
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GREEN VALLEY HOME HEALTH CARE & HOSPICE, INC.
Practice address
3009 Douglas Blvd
160
Roseville, CA 95661-3859
Phone
(916) 757-6800
Fax
(916) 787-1001
NPI assigned
Sep 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Authorized official

Name
Mrs. Najmeen Sherazee
Title
President
Phone
(916) 801-7002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3009 Douglas Blvd
160
Roseville, CA 95661-3859

Mailing address

3009 Douglas Blvd
160
Roseville, CA 95661-3859
Phone (916) 757-6800

Other names 1

  • Green Valley Hospice,Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111012000718 CA Part A Provider - Hospice 7517139728 Practice locations: Roseville, CA

Hospice certification: CCN 551654

Legal name
GREEN VALLEY HOME HEALTH CARE & HOSPICE, INC.
Doing business as
GREEN VALLEY HOSPICE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 3, 2012
Last certification
Jul 22, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Aug 1, 2011 in CA
Enrollment address
3009 Douglas Blvd 160
Roseville, CA 95661-4231

Care Compare: Hospice

Medicare Care Compare
Listed as
Green Valley Hospice, IncCCN 551654
Ownership
For-Profit
Certified
Oct 3, 2012
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
05D2034099Green Valley Hospice, Inc.3009 Douglas Blvd, Suite 160, Roseville, CA 95661Certificate of waiverDec 15, 2027

National Provider Directory

National Provider Directory

Locations

3009 Douglas Blvd
Ste 160
Roseville, CA 95661
Phone (916) 757-6800

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Najmeen Sherazee Individual 5% Or Greater Direct Ownership Interest Sep 21, 2011 67%
Corporate OfficerPresident Sep 21, 2011 67%
Corporate DirectorAdministrator Jan 12, 2016 67%
W-2 Managing EmployeePresident - Administrator Sep 21, 2011 67%
Naeem Wahab Individual 5% Or Greater Indirect Ownership Interest Aug 1, 2011 33%
Corporate OfficerBoard Member Aug 29, 2011 33%

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 6

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": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1780966796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 DOUGLAS BLVD",
            "address_2": "160",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613859",
            "telephone_number": "916-757-6800",
            "fax_number": "916-787-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 DOUGLAS BLVD",
            "address_2": "160",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613859",
            "telephone_number": "916-757-6800",
            "fax_number": "916-787-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN VALLEY HOME HEALTH CARE & HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "SHERAZEE",
        "authorized_official_first_name": "NAJMEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-801-7002",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Valley Hospice,Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.