Provider Demographics
NPI:1154968600
Name:SADIE'S CARING HEARTS
Entity type:Organization
Organization Name:SADIE'S CARING HEARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAWANIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, BSN, RN, CCM
Authorized Official - Phone:314-920-7826
Mailing Address - Street 1:15604 BRUNSWICK MANOR CT
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-3471
Mailing Address - Country:US
Mailing Address - Phone:314-920-7826
Mailing Address - Fax:
Practice Address - Street 1:15604 BRUNSWICK MANOR CT
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-3471
Practice Address - Country:US
Practice Address - Phone:314-920-7826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care