Healthcare Provider Details

I. General information

NPI: 1134066640
Provider Name (Legal Business Name): NEW PHASES GC COMPANION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 E JERSEY RD # 104
LEHIGH ACRES FL
33936-6330
US

IV. Provider business mailing address

104 E JERSEY RD # 104
LEHIGH ACRES FL
33936-6330
US

V. Phone/Fax

Practice location:
  • Phone: 516-412-1000
  • Fax: 516-412-1000
Mailing address:
  • Phone: 516-412-1000
  • Fax: 516-412-1000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RAMLA MCDONALD
Title or Position: OWNER / ADMINISTRATOR
Credential:
Phone: 516-412-1000