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NPI Code Detail

MEDICARE: SAGE HEALTH SERVICES, LLC

MEDICARE: SAGE HEALTH SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyC20110128-1214NV

General Provider Information

NPI Number : 1396117412
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAGE HEALTH SERVICES, LLC
Provider Business Mailing Address
First Line : PO BOX 82045
Second Line :
City : LAS VEGAS
State : NV
Zip : 89180-2045
Country : US
Telephone Number : 702-319-1555
Fax Number : 725-205-2895
Provider Business Practice Location Address
First Line : 8936 SPANISH RIDGE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1354
Country : US
Telephone Number : 702-319-1555
Fax Number : 725-205-2895
Authorized Official
Title or Position : COO
Name : JARED SHOEMAKER
Credential : BS, MA
Telephone Number : 702-319-1555
Provider Enumeration Date : 10/28/2015
Last Update Date : 07/11/2025

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