Provider Demographics
NPI:1033775200
Name:SACRED HEALTH CARE
Entity Type:Organization
Organization Name:SACRED HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IFY
Authorized Official - Middle Name:
Authorized Official - Last Name:OKWUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-283-0352
Mailing Address - Street 1:3123 FONTANA BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-4400
Mailing Address - Country:US
Mailing Address - Phone:469-298-9892
Mailing Address - Fax:
Practice Address - Street 1:3123 FONTANA BLVD
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-4400
Practice Address - Country:US
Practice Address - Phone:469-298-9892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No347C00000XTransportation ServicesPrivate Vehicle