Healthcare Provider Details

I. General information

NPI: 1013599638
Provider Name (Legal Business Name): REJOICE IN DIVERSITIES HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13758 E HIGHWAY 25 UNIT 3
OCKLAWAHA FL
32179-5306
US

IV. Provider business mailing address

PO BOX 1668
MOUNT DORA FL
32756-1668
US

V. Phone/Fax

Practice location:
  • Phone: 352-805-0734
  • Fax: 352-268-0923
Mailing address:
  • Phone: 352-805-0734
  • Fax: 352-268-0923

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 Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SIERRA PERRAS
Title or Position: OWNER
Credential:
Phone: 352-805-0734