Provider Demographics
NPI:1073114286
Name:SADIECARE HEALTH SERVICES INCORPORATED
Entity type:Organization
Organization Name:SADIECARE HEALTH SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:LENTON
Authorized Official - Last Name:O'NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-550-2241
Mailing Address - Street 1:483 HOLDERNESS ST SW UNIT B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-1748
Mailing Address - Country:US
Mailing Address - Phone:404-550-2241
Mailing Address - Fax:
Practice Address - Street 1:483 HOLDERNESS ST SW UNIT B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-1748
Practice Address - Country:US
Practice Address - Phone:404-550-2241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPHCP010775OtherGEORGIA DEPARTMENT OF COMMUNITY HEALTH