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NPI Code Detail

MEDICARE: SANCTUM HEALTH PARTNERS, LLC

MEDICARE: SANCTUM HEALTH PARTNERS, 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
1225100000XPhysical Therapist
2225X00000XOccupational Therapist
3235Z00000XSpeech-Language Pathologist
4251J00000XNursing Care Agency
5261QR0400XRehabilitation Clinic/Center
6251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598254989
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANCTUM HEALTH PARTNERS, LLC
Provider Business Mailing Address
First Line : 2121 MIDWAY RD STE 145
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-5263
Country : US
Telephone Number : 972-851-1022
Fax Number : 972-546-3118
Provider Business Practice Location Address
First Line : 2121 MIDWAY RD STE 145
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-5263
Country : US
Telephone Number : 972-851-1022
Fax Number : 972-546-3118
Authorized Official
Title or Position : PRESIDENT/COO
Name : JACOB JOHNSON
Credential :
Telephone Number : 972-851-1022
Provider Enumeration Date : 05/01/2018
Last Update Date : 10/23/2024

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Directions to “SANCTUM HEALTH PARTNERS, LLC ” Practice Location

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