Healthcare Provider Details

I. General information

NPI: 1518161405
Provider Name (Legal Business Name): SANCTUARY SKILLED HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 05/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 YAUGER RD
MT VERNON OH
43050-9272
US

IV. Provider business mailing address

PO BOX 345
SHARON CENTER OH
44274
US

V. Phone/Fax

Practice location:
  • Phone: 866-873-0323
  • Fax:
Mailing address:
  • Phone: 330-239-4480
  • Fax: 330-239-6224

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