MEDICARE: ALICIA DIANE MARSH CONNECTIONS FOR SENIORS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	228449	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548503550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALICIA DIANE MARSH CONNECTIONS FOR SENIORS

Provider Business Mailing Address
First Line	:	4241 ACLINE AVE
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286
Country	:	US
Telephone Number	:	941-486-8394
Fax Number	:	941-485-6451

Provider Business Practice Location Address
First Line	:	4241 ACLINE AVE
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286
Country	:	US
Telephone Number	:	941-486-8394
Fax Number	:	941-485-6451

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ALICIA DIANE MARSH
Credential	:
Telephone Number	:	941-486-8394

Provider Enumeration Date	:	03/28/2013
Last Update Date	:	08/08/2018

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