Provider Demographics
NPI:1598243800
Name:SURE WAY HOME HEALTHCARE
Entity Type:Organization
Organization Name:SURE WAY HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE TAKER
Authorized Official - Prefix:
Authorized Official - First Name:LATRICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-500-7601
Mailing Address - Street 1:4201 AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61101-2584
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 AUBURN ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61101-2584
Practice Address - Country:US
Practice Address - Phone:815-703-4712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health