NPIMap

Organization Active NPI

Customcare Hospice Services, Inc

  • Community Based Hospice Care Agency
  • Elk Grove, CA
National Provider Identifier
1851858807
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CUSTOMCARE HOSPICE SERVICES, INC
Practice address
8837 Elk Grove Blvd Ste B
Elk Grove, CA 95624-1828
Phone
(916) 714-1155
Fax
(916) 405-3434
NPI assigned
Feb 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Authorized official

Name
Audrey Acosta, RN
Title
Owner and Administrator
Phone
(916) 714-1155

Specialties & licenses 1

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

Addresses

Primary practice location

8837 Elk Grove Blvd Ste B
Elk Grove, CA 95624-1828

Mailing address

PO Box 2792
Elk Grove, CA 95759-2792
Phone (916) 714-1155

National Provider Directory

National Provider Directory
Tax ID family
Customcare Home Health Services Inc3 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

8837 Elk Grove Blvd
Ste B
Elk Grove, CA 95624
Phone (916) 714-1155

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1851858807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2792",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957592792",
            "telephone_number": "916-714-1155",
            "fax_number": "916-714-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8837 ELK GROVE BLVD STE B",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241828",
            "telephone_number": "916-714-1155",
            "fax_number": "916-405-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOMCARE HOSPICE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "OWNER AND ADMINISTRATOR",
        "authorized_official_telephone_number": "916-714-1155",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.