Healthcare Provider Details

I. General information

NPI: 1427983238
Provider Name (Legal Business Name): LIVE AT HOME SENIOR CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12536 5TH ISLE
HUDSON FL
34667-1932
US

IV. Provider business mailing address

12536 5TH ISLE
HUDSON FL
34667-1932
US

V. Phone/Fax

Practice location:
  • Phone: 727-877-7601
  • Fax:
Mailing address:
  • Phone: 727-877-7601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT BACON
Title or Position: CEO
Credential:
Phone: 727-615-4905