Healthcare Provider Details

I. General information

NPI: 1386136562
Provider Name (Legal Business Name): HOME SWEET HOME RESPITE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6831 SE 53RD PL
OCALA FL
34472-2097
US

IV. Provider business mailing address

6831 SE 53RD PL
OCALA FL
34472-2097
US

V. Phone/Fax

Practice location:
  • Phone: 352-512-8456
  • Fax:
Mailing address:
  • Phone: 352-512-8456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number234673
License Number StateFL

VIII. Authorized Official

Name: JONATHAN F THOMAS
Title or Position: OWNER/ADMINSTRATOR
Credential:
Phone: 352-512-8456