Provider Demographics
NPI:1447020987
Name:SANDRA LEE'S HOMES WITH HEARTS
Entity type:Organization
Organization Name:SANDRA LEE'S HOMES WITH HEARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PRIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:239-309-9192
Mailing Address - Street 1:216 SW 10TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-2551
Mailing Address - Country:US
Mailing Address - Phone:239-309-9192
Mailing Address - Fax:
Practice Address - Street 1:216 SW 10TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2551
Practice Address - Country:US
Practice Address - Phone:239-309-9192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health