1629259411 NPI number — FLORIDA CARING HANDS CORP

Table of content: (NPI 1629259411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629259411 NPI number — FLORIDA CARING HANDS CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLORIDA CARING HANDS CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629259411
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2301 S. HIGHWAY 17
Provider Second Line Business Mailing Address:
FLORIDA CARING HANDS CORP DBA APPLEHOUSE 1
Provider Business Mailing Address City Name:
CRESCENT CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
386-698-1444
Provider Business Mailing Address Fax Number:
386-698-2537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
422 PLESANT ST.
Provider Second Line Business Practice Location Address:
APPLEHOUSE 1
Provider Business Practice Location Address City Name:
POMONA PARK
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32181
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-698-1444
Provider Business Practice Location Address Fax Number:
386-698-2537
Provider Enumeration Date:
11/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VINARTA
Authorized Official First Name:
MARY ANN
Authorized Official Middle Name:
B
Authorized Official Title or Position:
RN/ADMINISTRATOR
Authorized Official Telephone Number:
386-698-1444

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  AL8345 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6981780101 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 142763600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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