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General NPI Number Information
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NPI Number | 1669874798
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Entity Type | Organization
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Legal Business Name | SACRED HEART HOME CARE INC
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 2504 E RIVER RD SUITE 100
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City | TUCSON
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State | AZ
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Zip | 85718-9555
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Country | US
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Telephone | 520-577-4630
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Fax | 520-577-4640
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Provider Business Mailing Address
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Address Line | 11244 STRANG LINE RD
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City | LENEXA
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State | KS
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Zip | 66215-4039
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Country | US
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Telephone | 913-322-1088
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Fax | 913-213-5608
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Authorized Official
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Title or Position | CEO
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Name | MR. ROBERT BLEVINS
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Credential |
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Telephone | 913-322-1088
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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 | HHA6820
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License Number State | AZ
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