Healthcare Provider Details

I. General information

NPI: 1033984331
Provider Name (Legal Business Name): WITH CARE HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4802 51ST ST W APT 421
BRADENTON FL
34210-5105
US

IV. Provider business mailing address

4802 51ST ST W APT 421
BRADENTON FL
34210-5105
US

V. Phone/Fax

Practice location:
  • Phone: 941-281-6276
  • Fax:
Mailing address:
  • Phone: 941-281-6276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health 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: ANTWAIN NICOLANDO WILLIAMS
Title or Position: OWNER
Credential:
Phone: 941-281-6276