Healthcare Provider Details

I. General information

NPI: 1295453066
Provider Name (Legal Business Name): GENTLE HOME CARE OF CENTRAL FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 11/11/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 SPRINGS COLONY CIR APT 397
ALTAMONTE SPRINGS FL
32714-5168
US

IV. Provider business mailing address

253 SPRINGS COLONY CIR APT 397
ALTAMONTE SPRINGS FL
32714-5168
US

V. Phone/Fax

Practice location:
  • Phone: 689-500-8879
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SHEREE ALEXANDER
Title or Position: OWNER/SOLE MBR
Credential:
Phone: 689-500-8879