Provider Demographics
NPI:1588238752
Name:SANCTUM GROUP, INC
Entity Type:Organization
Organization Name:SANCTUM GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:LAFRONZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-415-8340
Mailing Address - Street 1:1122 ROUTE 22 STE 206
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2813
Mailing Address - Country:US
Mailing Address - Phone:908-408-5220
Mailing Address - Fax:908-228-5215
Practice Address - Street 1:1122 ROUTE 22 STE 206
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2813
Practice Address - Country:US
Practice Address - Phone:908-408-5220
Practice Address - Fax:908-228-5215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty