Provider Demographics
NPI:1689325854
Name:SENTIENT HARBOR LLC
Entity Type:Organization
Organization Name:SENTIENT HARBOR LLC
Other - Org Name:SENTIENT HARBOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:N
Authorized Official - Last Name:STUMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-388-6466
Mailing Address - Street 1:PO BOX 2543
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:AZ
Mailing Address - Zip Code:85936-2543
Mailing Address - Country:US
Mailing Address - Phone:928-388-6466
Mailing Address - Fax:
Practice Address - Street 1:725 N 13TH W
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:AZ
Practice Address - Zip Code:85936-4849
Practice Address - Country:US
Practice Address - Phone:928-388-6466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility