Provider Demographics
NPI:1558692749
Name:S.A.I.L. SOLO HEALTH CARE, LLC
Entity Type:Organization
Organization Name:S.A.I.L. SOLO HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BERNICE
Authorized Official - Middle Name:K
Authorized Official - Last Name:HAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:814-572-0480
Mailing Address - Street 1:629 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4611
Mailing Address - Country:US
Mailing Address - Phone:814-572-0480
Mailing Address - Fax:
Practice Address - Street 1:1001 STATE ST
Practice Address - Street 2:SUITE 1123
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1814
Practice Address - Country:US
Practice Address - Phone:814-392-5389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN271769L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health