Provider Demographics
NPI:1679739171
Name:SACRED HEART HOMES, INC.
Entity Type:Organization
Organization Name:SACRED HEART HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:B.S.N., R.N.
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:G
Authorized Official - Last Name:DATINGALING-PANALIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-277-8721
Mailing Address - Street 1:3418 E INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-5113
Mailing Address - Country:US
Mailing Address - Phone:602-277-8721
Mailing Address - Fax:602-224-1357
Practice Address - Street 1:3828 N 36TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5106
Practice Address - Country:US
Practice Address - Phone:602-515-0783
Practice Address - Fax:602-224-1357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALH-6720311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home