Healthcare Provider Details

I. General information

NPI: 1538895974
Provider Name (Legal Business Name): A SPECIAL PLACE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3602 SE 47TH TER
OCALA FL
34480-9061
US

IV. Provider business mailing address

603 E FORT KING ST # 1142
OCALA FL
34471-2235
US

V. Phone/Fax

Practice location:
  • Phone: 352-207-7918
  • Fax:
Mailing address:
  • Phone: 352-207-7918
  • 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: MRS. FELECIA BURGESS-WILLIAMS
Title or Position: CEO
Credential:
Phone: 352-207-7918