Provider Demographics
NPI:1891314498
Name:SABMARC LLC
Entity Type:Organization
Organization Name:SABMARC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MODESTUS
Authorized Official - Middle Name:C
Authorized Official - Last Name:ONYEGBULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-654-1503
Mailing Address - Street 1:24622 HEIRLOOM LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-2885
Mailing Address - Country:US
Mailing Address - Phone:832-654-1503
Mailing Address - Fax:
Practice Address - Street 1:24622 HEIRLOOM LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2885
Practice Address - Country:US
Practice Address - Phone:832-654-1503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care