Organization
SANCTUARY HOME CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAJA CALVIN (CEO)
(765) 247-0837
Entity
Organization
Contact information
Practice address
1048B SAGAMORE PKWY W # 1011, WEST LAFAYETTE, IN 47906-1446
(765) 247-0837
(765) 478-7005
Mailing address
1048B SAGAMORE PKWY W # 1011, WEST LAFAYETTE, IN 47906-1446
(765) 247-0837
(765) 478-7005
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083231823
HOME CARE AGENCY
IN
Enumeration date
09/05/2020
Last updated
09/06/2020
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