Provider Demographics
NPI:1760655625
Name:SANCTIFIED HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:SANCTIFIED HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IJEOMA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:EHIEZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-244-3418
Mailing Address - Street 1:2719 MARQUETTE TRL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5576
Mailing Address - Country:US
Mailing Address - Phone:832-244-3418
Mailing Address - Fax:281-665-1224
Practice Address - Street 1:2719 MARQUETTE TRL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5576
Practice Address - Country:US
Practice Address - Phone:832-244-3418
Practice Address - Fax:281-665-1224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747713Medicare PIN