Provider Demographics
NPI:1679975148
Name:SACRED HEART HEALTH CARE CORPORATION
Entity Type:Organization
Organization Name:SACRED HEART HEALTH CARE CORPORATION
Other - Org Name:SHHCC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:INFANTE
Authorized Official - Last Name:VILLAROSA
Authorized Official - Suffix:JR
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:219-741-0254
Mailing Address - Street 1:7870 BROADWAY
Mailing Address - Street 2:SUITE G
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5542
Mailing Address - Country:US
Mailing Address - Phone:219-741-0254
Mailing Address - Fax:
Practice Address - Street 1:7870 BROADWAY
Practice Address - Street 2:SUITE G
Practice Address - City:MERILVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410
Practice Address - Country:US
Practice Address - Phone:219-741-0254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization