Healthcare Provider Details

I. General information

NPI: 1184304214
Provider Name (Legal Business Name): DW CARES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 S MAIN ST
HAVANA FL
32333-2227
US

IV. Provider business mailing address

920 S MAIN ST
HAVANA FL
32333-2227
US

V. Phone/Fax

Practice location:
  • Phone: 850-755-1760
  • Fax:
Mailing address:
  • Phone: 850-755-1760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: DEXTER WHITE
Title or Position: OWNER
Credential:
Phone: 850-755-1760