Provider Demographics
NPI:1235342783
Name:S.A.G.E., INC
Entity Type:Organization
Organization Name:S.A.G.E., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCRUGGS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:908-659-9669
Mailing Address - Street 1:1156 LIBERTY AVE
Mailing Address - Street 2:2ND FLOOR, SUITE 7
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2142
Mailing Address - Country:US
Mailing Address - Phone:908-659-9669
Mailing Address - Fax:908-659-9667
Practice Address - Street 1:1156 LIBERTY AVE
Practice Address - Street 2:2ND FLOOR, SUITE 7
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-2142
Practice Address - Country:US
Practice Address - Phone:908-659-9669
Practice Address - Fax:908-659-9667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0036000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9036601Medicaid