Healthcare Provider Details

I. General information

NPI: 1336711688
Provider Name (Legal Business Name): KOLIBRI HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3353 BRADSHAW RD STE 205
SACRAMENTO CA
95827-2610
US

IV. Provider business mailing address

6817 WESTMORE WAY
CARMICHAEL CA
95608-1539
US

V. Phone/Fax

Practice location:
  • Phone: 916-538-2727
  • Fax: 833-649-2639
Mailing address:
  • Phone: 916-538-2727
  • Fax: 833-649-2639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LUIS LUZZATTI
Title or Position: OWNER
Credential:
Phone: 916-221-1686