Provider Demographics
NPI:1821276387
Name:SANCTUARY SKILLED HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:SANCTUARY SKILLED HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-239-4474
Mailing Address - Street 1:1383 SHARON COPLEY RD
Mailing Address - Street 2:
Mailing Address - City:SHARON CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:44274
Mailing Address - Country:US
Mailing Address - Phone:330-239-4474
Mailing Address - Fax:330-239-4479
Practice Address - Street 1:860 E IRON AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2031
Practice Address - Country:US
Practice Address - Phone:330-364-9698
Practice Address - Fax:330-364-9438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3094173Medicaid
OH368303Medicare PIN