Provider Demographics
NPI:1669778312
Name:SACRED HEART HEALTH CARE SERVICES
Entity type:Organization
Organization Name:SACRED HEART HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HERVE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-446-3554
Mailing Address - Street 1:1474 SW 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-6015
Mailing Address - Country:US
Mailing Address - Phone:954-446-3554
Mailing Address - Fax:
Practice Address - Street 1:1474 SW 26TH AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-6015
Practice Address - Country:US
Practice Address - Phone:954-446-3554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5186836164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty