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General NPI Number Information
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NPI Number | 1316851876
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Entity Type | Organization
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Legal Business Name | SWEETWATER SANCTUARY, INC.
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 3001 SANCTUARY LN
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City | FREDERICK
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State | MD
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Zip | 21701-6807
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Country | US
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Telephone | 703-835-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 SANCTUARY LN
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City | FREDERICK
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State | MD
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Zip | 21701-6807
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Country | US
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Telephone | 703-835-3900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN LEE HOLT
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Credential |
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Telephone | 703-835-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | NULL
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