Provider Demographics
NPI:1235838624
Name:SAGE HEALTH AT HOME LLC
Entity Type:Organization
Organization Name:SAGE HEALTH AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:PERISSINOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-688-3313
Mailing Address - Street 1:3100 INTERSTATE NORTH CIR SE STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2384
Mailing Address - Country:US
Mailing Address - Phone:678-888-3313
Mailing Address - Fax:678-888-4229
Practice Address - Street 1:3100 INTERSTATE NORTH CIR SE STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2384
Practice Address - Country:US
Practice Address - Phone:678-888-3313
Practice Address - Fax:678-888-4229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1790963502OtherNPPES