Healthcare Provider Details

I. General information

NPI: 1366802332
Provider Name (Legal Business Name): SENTECH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2016
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 SW 29TH TERR APT.D
GAINESVILLE FL
32608
US

IV. Provider business mailing address

3500 SW 29TH TER APT.D
GAINESVILLE FL
32608-7644
US

V. Phone/Fax

Practice location:
  • Phone: 352-214-6634
  • Fax:
Mailing address:
  • Phone: 352-214-6634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LASHAWN EZELL
Title or Position: OWNER
Credential:
Phone: 352-214-6634