Healthcare Provider Details

I. General information

NPI: 1124567714
Provider Name (Legal Business Name): SWEET HOME ADULT DAY CARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2017
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 PLAZA DRIVE SUITE #102
LEHIGH ACRES FL
33936
US

IV. Provider business mailing address

201 PLAZA DRIVE SUITE #102
LEHIGH ACRES FL
33936
US

V. Phone/Fax

Practice location:
  • Phone: 786-251-1632
  • Fax: 239-491-9359
Mailing address:
  • Phone: 786-251-1632
  • Fax: 239-491-9359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9358
License Number StateFL

VIII. Authorized Official

Name: NANCY ASCANIO
Title or Position: OWNER
Credential:
Phone: 786-251-1632