Provider Demographics
NPI:1992924930
Name:SAGRADO CORAZON DE JESUS HOME CARE INC
Entity type:Organization
Organization Name:SAGRADO CORAZON DE JESUS HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIDAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, DON
Authorized Official - Phone:786-333-3126
Mailing Address - Street 1:5209 NW 74TH AVE
Mailing Address - Street 2:SUITE # 226
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4800
Mailing Address - Country:US
Mailing Address - Phone:786-333-3126
Mailing Address - Fax:
Practice Address - Street 1:5209 NW 74TH AVE
Practice Address - Street 2:SUITE # 226
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-4800
Practice Address - Country:US
Practice Address - Phone:786-333-3126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health