Provider Demographics
NPI:1790189306
Name:SAGE HEALTH CARE LLC
Entity Type:Organization
Organization Name:SAGE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:BRILL
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:CNP, MS
Authorized Official - Phone:970-946-0055
Mailing Address - Street 1:88 MAGPIE TRL
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-6993
Mailing Address - Country:US
Mailing Address - Phone:970-403-8812
Mailing Address - Fax:970-403-8815
Practice Address - Street 1:1911 MAIN AVE STE 255
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5083
Practice Address - Country:US
Practice Address - Phone:970-403-8812
Practice Address - Fax:970-403-8815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-11
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QP2300X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care