=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972959393
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SASHI'S GARDEN INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2016
-----------------------------------------------------
Last Update Date | 05/05/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 209 SE 3RD ST
-----------------------------------------------------
City | HALLANDALE BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33009-5646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-455-1799
-----------------------------------------------------
Fax | 954-455-1799
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 209 SE 3RD ST
-----------------------------------------------------
City | HALLANDALE BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33009-5646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-455-1799
-----------------------------------------------------
Fax | 954-455-1799
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. SASHI MARIE SANCHEZ
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 954-455-1799
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number | PN5158415
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------