Healthcare Provider Details

I. General information

NPI: 1982900304
Provider Name (Legal Business Name): SANCTUARY SKILLED HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2011
Last Update Date: 05/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E. 26 ST
ASHTABULA OH
44004-5061
US

IV. Provider business mailing address

PO BOX 427 1383 SHARON COPLEY RD
SHARON CENTER OH
44274
US

V. Phone/Fax

Practice location:
  • Phone: 440-992-7425
  • Fax: 440-992-0399
Mailing address:
  • Phone: 330-239-4474
  • Fax: 330-239-4479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JANET HARRIS
Title or Position: CEO
Credential:
Phone: 330-239-4474