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General NPI Number Information
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NPI Number | 1235838624
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Entity Type | Organization
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Legal Business Name | SAGE HEALTH AT HOME LLC
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 3100 INTERSTATE NORTH CIR SE STE 200
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City | ATLANTA
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State | GA
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Zip | 30339-2384
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Country | US
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Telephone | 678-888-3313
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Fax | 678-888-4229
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Provider Business Mailing Address
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Address Line | 3100 INTERSTATE NORTH CIR SE STE 200
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City | ATLANTA
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State | GA
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Zip | 30339-2384
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Country | US
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Telephone | 678-888-3313
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Fax | 678-888-4229
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. CARLA MARIA PERISSINOTTO
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Credential | MD
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Telephone | 678-688-3313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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