Provider Demographics
NPI:1275885006
Name:SACRED SOULS HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:SACRED SOULS HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARCHARAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-730-0356
Mailing Address - Street 1:8115 RIO GRANDE BLVD NW
Mailing Address - Street 2:
Mailing Address - City:LOS RANCHOS
Mailing Address - State:NM
Mailing Address - Zip Code:87114-1218
Mailing Address - Country:US
Mailing Address - Phone:505-730-0356
Mailing Address - Fax:
Practice Address - Street 1:8115 RIO GRANDE BLVD NW
Practice Address - Street 2:
Practice Address - City:LOS RANCHOS
Practice Address - State:NM
Practice Address - Zip Code:87114-1218
Practice Address - Country:US
Practice Address - Phone:505-730-0356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health