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General NPI Number Information
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NPI Number | 1043789076
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Entity Type | Organization
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Legal Business Name | SANCTUARY SKILLED HOME HEALTH CARE DOVER LLC
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 860 E IRON AVE
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City | DOVER
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State | OH
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Zip | 44622-2031
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Country | US
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Telephone | 330-239-3597
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Fax |
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Provider Business Mailing Address
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Address Line | 1343 SHARON COPLEY ROAD
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City | WADSWORTH
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State | OH
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Zip | 44281
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Country | US
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Telephone | 330-239-3597
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Fax |
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Authorized Official
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Title or Position | ATTORNEY
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Name | HAYLEY B WILLIAMS
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Credential |
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Telephone | 216-706-3936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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