Provider Demographics
NPI:1497255525
Name:SAI ENTERPRISE GROUP LLC
Entity type:Organization
Organization Name:SAI ENTERPRISE GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:MANSI
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-522-3724
Mailing Address - Street 1:586 INDIGO BAY CIR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-3684
Mailing Address - Country:US
Mailing Address - Phone:732-522-3724
Mailing Address - Fax:
Practice Address - Street 1:2220 HIGHWAY 17 NORTH
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-2957
Practice Address - Country:US
Practice Address - Phone:732-522-3724
Practice Address - Fax:732-522-3724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP-0807253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care