Healthcare Provider Details

I. General information

NPI: 1184547408
Provider Name (Legal Business Name): RIVER OF LIFE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10953 114TH ST PL N
LARGO FL
33778
US

IV. Provider business mailing address

10953 114TH PL
LARGO FL
33778-3348
US

V. Phone/Fax

Practice location:
  • Phone: 407-334-1276
  • Fax:
Mailing address:
  • Phone: 407-334-1276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: ARIDAY BENCOMO VILAU
Title or Position: OWNER
Credential:
Phone: 407-334-1276