Healthcare Provider Details

I. General information

NPI: 1093748865
Provider Name (Legal Business Name): CARING HANDS HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 N MAIN ST
HAVANA FL
32333-1652
US

IV. Provider business mailing address

313 N MAIN ST
HAVANA FL
32333-1652
US

V. Phone/Fax

Practice location:
  • Phone: 850-539-2335
  • Fax: 850-539-2334
Mailing address:
  • Phone: 850-539-2335
  • Fax: 850-539-2334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA29992179
License Number StateFL

VIII. Authorized Official

Name: MRS. ADEBUSOLA CORDOVA
Title or Position: ADMINISTRATOR
Credential: MSW
Phone: 85005392335