Provider Demographics
NPI:1326405663
Name:SOTERIA HOME HEALTH LLC
Entity Type:Organization
Organization Name:SOTERIA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIRLESS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-390-6440
Mailing Address - Street 1:8469 S SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2069
Mailing Address - Country:US
Mailing Address - Phone:810-625-8239
Mailing Address - Fax:810-771-7612
Practice Address - Street 1:8469 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2069
Practice Address - Country:US
Practice Address - Phone:810-625-8239
Practice Address - Fax:810-771-7612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health