Healthcare Provider Details

I. General information

NPI: 1164527214
Provider Name (Legal Business Name): HOSPICE OF THE FOOTHILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11270 ROUGH AND READY HWY
GRASS VALLEY CA
95945-8530
US

IV. Provider business mailing address

11270 ROUGH AND READY HWY
GRASS VALLEY CA
95945-8530
US

V. Phone/Fax

Practice location:
  • Phone: 530-272-5739
  • Fax:
Mailing address:
  • Phone: 530-272-5739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number100000763
License Number StateCA

VIII. Authorized Official

Name: MS. HEIDI WINGO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 530-274-5159