Healthcare Provider Details

I. General information

NPI: 1437073616
Provider Name (Legal Business Name): TO BE CHOSEN HOMEMAKING AND COMPANION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 SE CASTILLO TER
LAKE CITY FL
32025-5427
US

IV. Provider business mailing address

417 SE CASTILLO TER
LAKE CITY FL
32025-5427
US

V. Phone/Fax

Practice location:
  • Phone: 386-697-3484
  • Fax: 386-697-3484
Mailing address:
  • Phone: 386-697-3484
  • Fax: 386-697-3484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: LATEARRA MITCHELL
Title or Position: ADMINISTRATOR
Credential:
Phone: 386-697-3484