Healthcare Provider Details

I. General information

NPI: 1588171979
Provider Name (Legal Business Name): A PLACE CALLED SWEET HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2018
Last Update Date: 05/08/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4360 WEST VINE ST
KISSIMMEE FL
34746-6313
US

IV. Provider business mailing address

4360 WEST VINE ST
KISSIMMEE FL
34746
US

V. Phone/Fax

Practice location:
  • Phone: 888-791-5754
  • Fax: 877-202-9070
Mailing address:
  • Phone: 888-791-5754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9407
License Number StateFL

VIII. Authorized Official

Name: IVETTE SALVAT RODRIGUEZ
Title or Position: OWNER
Credential:
Phone: 407-460-4573