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General NPI Number Information
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NPI Number | 1982226585
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Entity Type | Organization
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Legal Business Name | SAGE HEALTHCARE SERVICES INC
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 06/23/2020
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Provider Practice Location Address
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Address Line | 10855 CHURCH ST APT 1404
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-8582
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Country | US
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Telephone | 870-413-1652
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Fax | 316-661-1769
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Provider Business Mailing Address
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Address Line | 10855 CHURCH ST APT 1404
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-8582
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Country | US
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Telephone | 870-413-1652
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Fax | 316-661-1769
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Authorized Official
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Title or Position | DIRECTOR
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Name | STELLA KEMUNTO ONDIEKI
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Credential | NP
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Telephone | 870-413-1652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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