Provider Demographics
NPI:1598288243
Name:SANDI FLORES CONSULTING GROUP
Entity Type:Organization
Organization Name:SANDI FLORES CONSULTING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-388-7297
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PLAINS
Mailing Address - State:AR
Mailing Address - Zip Code:72568-0040
Mailing Address - Country:US
Mailing Address - Phone:501-388-7297
Mailing Address - Fax:
Practice Address - Street 1:141 COYOTE LN
Practice Address - Street 2:
Practice Address - City:PLEASANT PLAINS
Practice Address - State:AR
Practice Address - Zip Code:72568-9800
Practice Address - Country:US
Practice Address - Phone:501-388-7297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA475523251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care