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General NPI Number Information
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NPI Number | 1992321095
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Entity Type | Organization
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Legal Business Name | SASS.ILLY ENDEAVORS, INC.
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Dates
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Enumeration Date | 06/24/2020
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 1300 METRO EAST DR STE 110
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City | PLEASANT HILL
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State | IA
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Zip | 50327-8906
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Country | US
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Telephone | 515-243-0011
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Fax | 515-243-7711
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Provider Business Mailing Address
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Address Line | 1300 METRO EAST DR STE 110
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City | PLEASANT HILL
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State | IA
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Zip | 50327-8906
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Country | US
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Telephone | 515-243-0011
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Fax | 515-243-7711
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Authorized Official
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Title or Position | OWNER
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Name | SHASTA LEE GAMBLE
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Credential |
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Telephone | 515-243-0011
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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