Healthcare Provider Details

I. General information

NPI: 1083530190
Provider Name (Legal Business Name): MRS. LORI KIM SAKACS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14250 LISBON RD
SALEM OH
44460-9212
US

IV. Provider business mailing address

14250 LISBON RD
SALEM OH
44460-9212
US

V. Phone/Fax

Practice location:
  • Phone: 234-567-2777
  • Fax:
Mailing address:
  • Phone: 234-567-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: