Healthcare Provider Details

I. General information

NPI: 1457708372
Provider Name (Legal Business Name): NANI'S TOUCH OF CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4608 SE 1ST PL
GAINESVILLE FL
32641-7601
US

IV. Provider business mailing address

1900 SE 4TH ST APT 158
GAINESVILLE FL
32641-8791
US

V. Phone/Fax

Practice location:
  • Phone: 352-284-6169
  • 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 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 TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANGELA RENEE DAVIS
Title or Position: HEALTH TECHNICIAN/ C.N.A
Credential:
Phone: 352-284-6169