Healthcare Provider Details

I. General information

NPI: 1508629080
Provider Name (Legal Business Name): INFINITE HOME COMPANIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 STERNS DR
LEESBURG FL
34748-2019
US

IV. Provider business mailing address

1624 STERNS DR
LEESBURG FL
34748-2019
US

V. Phone/Fax

Practice location:
  • Phone: 352-460-9306
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY BARRETT
Title or Position: ADMINISTRATOR
Credential:
Phone: 352-460-9306