MEDICARE: FAVOR HOME CARE SERVICES 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1992391049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAVOR HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	10668 NEW EAST BAY DR
Second Line	:
City	:	GIBSONTON
State	:	FL
Zip	:	33534-5028
Country	:	US
Telephone Number	:	832-228-7723
Fax Number	:

Provider Business Practice Location Address
First Line	:	1211 TECH BLVD STE 122
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-7846
Country	:	US
Telephone Number	:	832-228-7723
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MONICAH MUHANJI
Credential	:
Telephone Number	:	832-228-7723

Provider Enumeration Date	:	12/14/2020
Last Update Date	:	03/17/2021

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