Healthcare Provider Details

I. General information

NPI: 1235875139
Provider Name (Legal Business Name): AT EASE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 ELLIS SANFORD RD
PARRISH AL
35580-6061
US

IV. Provider business mailing address

505 ELLIS SANFORD RD
PARRISH AL
35580-6061
US

V. Phone/Fax

Practice location:
  • Phone: 205-544-6923
  • Fax:
Mailing address:
  • Phone: 205-544-6923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MR. ZACHARY SCOTT SANFORD
Title or Position: CEO
Credential: RN
Phone: 205-544-6923