Provider Demographics
NPI:1063025872
Name:SANCTUARY HOME HEALTH AGENCY, LLC
Entity Type:Organization
Organization Name:SANCTUARY HOME HEALTH AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER/BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:912-682-3430
Mailing Address - Street 1:160 MEDICAL CIR STE C
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3639
Mailing Address - Country:US
Mailing Address - Phone:912-682-3430
Mailing Address - Fax:803-753-9227
Practice Address - Street 1:160 MEDICAL CIR STE C
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3639
Practice Address - Country:US
Practice Address - Phone:912-682-3430
Practice Address - Fax:803-753-9227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health