MEDICARE: BETTER AT HOME, LLC.

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	251J00000X	Nursing Care Agency	30211371	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30211371	OTHER	FL	AHCA NURSE REGISTRY LICENSE NUMBER

General Provider Information

NPI Number	:	1780839357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETTER AT HOME, LLC.

Provider Business Mailing Address
First Line	:	7520 W WATERS AVE
Second Line	:	SUITE 19
City	:	TAMPA
State	:	FL
Zip	:	33615-1599
Country	:	US
Telephone Number	:	813-374-0309
Fax Number	:	813-902-7196

Provider Business Practice Location Address
First Line	:	7520 W WATERS AVE
Second Line	:	SUITE 19
City	:	TAMPA
State	:	FL
Zip	:	33615-1599
Country	:	US
Telephone Number	:	813-374-0309
Fax Number	:	813-902-7196

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LUCY VIOLETA STEWART
Credential	:	R.N.
Telephone Number	:	813-374-0309

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	01/13/2014

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