Provider Demographics
NPI:1730908302
Name:LIVING SANCTUARY 1 HEALTH CARE SERVICES
Entity type:Organization
Organization Name:LIVING SANCTUARY 1 HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ONI
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS, MBA
Authorized Official - Phone:856-986-8237
Mailing Address - Street 1:4 MAHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-3252
Mailing Address - Country:US
Mailing Address - Phone:856-986-8237
Mailing Address - Fax:
Practice Address - Street 1:1358 WHITMAN AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08104-1264
Practice Address - Country:US
Practice Address - Phone:856-365-3509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health