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General NPI Number Information
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NPI Number | 1356022065
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Entity Type | Organization
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Legal Business Name | SACRED HEARTS ASSISTED LIVING LLC
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 10772 ROSALINA LOOP
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City | CONVERSE
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State | TX
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Zip | 78109-4450
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Country | US
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Telephone | 210-410-3250
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Fax |
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Provider Business Mailing Address
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Address Line | 830 NORTH BLVD UNIT 2273
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City | UNIVERSAL CITY
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State | TX
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Zip | 78148-2311
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Country | US
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Telephone | 210-331-4341
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR/COO
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Name | MS. LEDALE LASHETTE FIELDS
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Credential |
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Telephone | 210-410-3250
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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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