Provider Demographics
NPI:1275605925
Name:SACRED HEART OF JESUS NURSING CARE INC
Entity Type:Organization
Organization Name:SACRED HEART OF JESUS NURSING CARE INC
Other - Org Name:HOME HEALTH CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FERDINAND
Authorized Official - Middle Name:C
Authorized Official - Last Name:SANGLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-258-0441
Mailing Address - Street 1:9660 FLAIR DR
Mailing Address - Street 2:425
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731
Mailing Address - Country:US
Mailing Address - Phone:626-258-0441
Mailing Address - Fax:626-258-0442
Practice Address - Street 1:9660 FLAIR DR
Practice Address - Street 2:425
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3017
Practice Address - Country:US
Practice Address - Phone:626-258-0441
Practice Address - Fax:626-258-0442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA557670Medicare Oscar/Certification