Provider Demographics
NPI:1366907685
Name:BIG HEARTS HOSPICE CARE
Entity type:Organization
Organization Name:BIG HEARTS HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEROBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-389-0877
Mailing Address - Street 1:9812 OLD WINERY PL STE 4
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1732
Mailing Address - Country:US
Mailing Address - Phone:916-389-0877
Mailing Address - Fax:
Practice Address - Street 1:9812 OLD WINERY PL STE 4
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1732
Practice Address - Country:US
Practice Address - Phone:916-389-0877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-01
Last Update Date:2024-03-19
Deactivation Date:2024-03-12
Deactivation Code:
Reactivation Date:2024-03-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1Medicaid