Provider Demographics
NPI:1124428552
Name:SACRED HEART NURSING
Entity type:Organization
Organization Name:SACRED HEART NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:DATINGALING
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN
Authorized Official - Phone:602-277-8721
Mailing Address - Street 1:3418 E INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-5113
Mailing Address - Country:US
Mailing Address - Phone:602-277-8721
Mailing Address - Fax:602-224-1357
Practice Address - Street 1:3418 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5113
Practice Address - Country:US
Practice Address - Phone:602-277-8721
Practice Address - Fax:602-224-1357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07-382756-K251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care