Healthcare Provider Details

I. General information

NPI: 1659810448
Provider Name (Legal Business Name): ORCHARD PARK ADULT FAMILY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 GRAPEVINE CRST
OCOEE FL
34761-7729
US

IV. Provider business mailing address

2755 GRAPEVINE CRST
OCOEE FL
34761-7729
US

V. Phone/Fax

Practice location:
  • Phone: 407-491-5727
  • Fax:
Mailing address:
  • Phone: 407-491-5727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number6906857
License Number StateFL

VIII. Authorized Official

Name: RESHMA SINGH
Title or Position: ADMINISTRATOR
Credential:
Phone: 407-491-5727