Healthcare Provider Details

I. General information

NPI: 1710036397
Provider Name (Legal Business Name): HESTIA HEALTHCARE AT HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1926 10TH AVE N STE 205
LAKE WORTH BEACH FL
33461-3300
US

IV. Provider business mailing address

1 PARK PLZ
NASHVILLE TN
37203-6527
US

V. Phone/Fax

Practice location:
  • Phone: 561-686-1876
  • Fax:
Mailing address:
  • Phone: 615-344-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299991870
License Number StateFL

VIII. Authorized Official

Name: WILLIAM BRADLEY PARRISH
Title or Position: CFO, HOME HEALTH & HOSPICE
Credential:
Phone: 512-565-8439