Provider Demographics
NPI:1528703790
Name:SAGRADO WELLNESS INC.
Entity type:Organization
Organization Name:SAGRADO WELLNESS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FAVIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:520-535-3194
Mailing Address - Street 1:PO BOX 43492
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3492
Mailing Address - Country:US
Mailing Address - Phone:520-535-3194
Mailing Address - Fax:520-337-0898
Practice Address - Street 1:2030 E BROADWAY BLVD STE 12
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-5907
Practice Address - Country:US
Practice Address - Phone:520-535-3194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty