Provider Demographics
NPI:1982226585
Name:SAGE HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:SAGE HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:KEMUNTO
Authorized Official - Last Name:ONDIEKI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:870-413-1652
Mailing Address - Street 1:10855 CHURCH ST APT 1404
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8582
Mailing Address - Country:US
Mailing Address - Phone:870-413-1652
Mailing Address - Fax:316-661-1769
Practice Address - Street 1:10855 CHURCH ST APT 1404
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-8582
Practice Address - Country:US
Practice Address - Phone:870-413-1652
Practice Address - Fax:316-661-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty