Provider Demographics
NPI:1376088450
Name:MAGOCHA, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MAGOCHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 WINDY KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-5338
Mailing Address - Country:US
Mailing Address - Phone:231-872-0422
Mailing Address - Fax:
Practice Address - Street 1:902 MORNINGSIDE LN
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-4595
Practice Address - Country:US
Practice Address - Phone:231-872-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home