Healthcare Provider Details

I. General information

NPI: 1912652447
Provider Name (Legal Business Name): OHARA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2022
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 E MAIN ST STE 6
HAINES CITY FL
33844-4241
US

IV. Provider business mailing address

651 E MAIN ST STE 6
HAINES CITY FL
33844-4241
US

V. Phone/Fax

Practice location:
  • Phone: 863-521-5629
  • Fax:
Mailing address:
  • Phone: 863-521-5629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: JOY GENUNG
Title or Position: OWNER
Credential:
Phone: 253-226-1177