Provider Demographics
NPI:1225890254
Name:SAGE ROSE HEALTH
Entity Type:Organization
Organization Name:SAGE ROSE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:PANEK
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:303-351-2324
Mailing Address - Street 1:5750 DTC PKWY STE 185
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3226
Mailing Address - Country:US
Mailing Address - Phone:303-351-2324
Mailing Address - Fax:
Practice Address - Street 1:5750 DTC PKWY STE 185
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3226
Practice Address - Country:US
Practice Address - Phone:303-351-2324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty