Sacred Trust Healthcare Services LLC

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

Legal business name

SACRED TRUST HEALTHCARE SERVICES LLC

Doing business as

Sacred Trust Healthcare

Practice address

503 Magnolia St
Palatka, FL 32177-8194

Phone

(386) 916-7582

Fax

(504) 324-3603

NPI assigned

Apr 12, 2016

Last updated

Apr 12, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Corey Thomas

Title

Administrator

Phone

(386) 916-7582

Specialties & licenses 3

Addresses

Other names 1

• Sacred Trust Healthcare Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1942664248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 OXFORD PL",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700563054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 MAGNOLIA ST",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321778194",
            "telephone_number": "386-916-7582",
            "fax_number": "504-324-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED TRUST HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-916-7582",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacred Trust Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rural Health Care, Incorporated (Aza Health)
• Audrey M Russell, PHARMACY TECH
• Kathleen Anne Russell, ARNP-BC
• Nancy Russo, LMHC
• S S Marathe MD PA (Medical Specialists PA)
• Jennifer L. Sadler, L.P.N.
• Virginia T Saldajeno, RPH
• Saltzman, Tanis, Pittel, Levin and Jacobson, LLC (Pediatric Associates)
• Christopher Willard Vincent Salzman, M.D.
• Makarios Samir, DC

• Physical Disabilities Residential Treatment Facility in Palatka, FL
• Providers in Palatka, FL by specialty
• Physical Disabilities Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.