MEDICARE: CELESTAL CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	374U00000X	Home Health Aide
3	385H00000X	Respite Care
4	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1447039680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CELESTAL CARE, LLC

Provider Business Mailing Address
First Line	:	2022 THRACE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33605-6354
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2022 THRACE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33605-6354
Country	:	US
Telephone Number	:	813-445-0224
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. LIA HARRIS
Credential	:
Telephone Number	:	813-445-0224

Provider Enumeration Date	:	09/26/2023
Last Update Date	:	09/26/2023

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