Provider Demographics
NPI:1093398034
Name:SAGENCY LLC
Entity Type:Organization
Organization Name:SAGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHALOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-817-9461
Mailing Address - Street 1:39620 WASHINGTON ST STE C
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-4137
Mailing Address - Country:US
Mailing Address - Phone:619-817-9461
Mailing Address - Fax:
Practice Address - Street 1:39620 WASHINGTON ST STE C
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-4137
Practice Address - Country:US
Practice Address - Phone:619-817-9461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care