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General NPI Number Information
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NPI Number | 1780276675
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Entity Type | Organization
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Legal Business Name | SABREEN VILLAGE LLC
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Dates
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Enumeration Date | 02/11/2021
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Last Update Date | 02/11/2021
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Provider Practice Location Address
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Address Line | 1021 BELLAIR CT APT 9
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City | NILES
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State | OH
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Zip | 44446-1080
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Country | US
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Telephone | 330-219-4134
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 BELLAIR CT APT 9
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City | NILES
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State | OH
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Zip | 44446-1080
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Country | US
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Telephone | 330-219-4134
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RASHEDA PROVITT
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Credential |
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Telephone | 330-219-4134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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