Provider Demographics
NPI:1518780196
Name:FLORES-VALLE, SARAH LOUISE (NA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LOUISE
Last Name:FLORES-VALLE
Suffix:
Gender:F
Credentials:NA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LOUISE
Other - Last Name:VANGUILDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MARRIED
Mailing Address - Street 1:195252 L DR N
Mailing Address - Street 2:
Mailing Address - City:MARSHALL,MI
Mailing Address - State:MI
Mailing Address - Zip Code:49068
Mailing Address - Country:US
Mailing Address - Phone:517-677-3224
Mailing Address - Fax:
Practice Address - Street 1:195252 L DR N
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068
Practice Address - Country:US
Practice Address - Phone:517-677-3224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI93-4406273253Z00000X, 385H00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care