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General NPI Number Information
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NPI Number | 1699933937
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Entity Type | Organization
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Legal Business Name | SANDY HOME CARE SERVICES
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 39630 PLEASANT AVE
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City | SANDY
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State | OR
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Zip | 97055-6476
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Country | US
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Telephone | 503-826-8285
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Fax | 503-668-9500
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Provider Business Mailing Address
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Address Line | 39630 PLEASANT AVE P.O. BOX 1478
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City | SANDY
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State | OR
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Zip | 97055-6476
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Country | US
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Telephone | 503-826-8285
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Fax | 503-668-9500
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Authorized Official
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Title or Position | OWNER
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Name | MARY SANDERCOCK
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Credential |
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Telephone | 503-826-8285
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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 | 15-2011
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License Number State | OR
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