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General NPI Number Information
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NPI Number | 1780360875
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Entity Type | Organization
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Legal Business Name | BLACKHAWK HEALTHCARE INC.
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Dates
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Enumeration Date | 06/23/2023
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 3160 CROW CANYON RD # 160C
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City | SAN RAMON
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State | CA
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Zip | 94583-1368
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Country | US
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Telephone | 925-575-8900
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Fax | 925-241-0655
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Provider Business Mailing Address
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Address Line | 3160 CROW CANYON RD # 160C
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City | SAN RAMON
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State | CA
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Zip | 94583-1368
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Country | US
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Telephone | 925-575-8900
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Fax | 925-241-0655
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | RISHI MEHTA
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Credential |
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Telephone | 925-575-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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