Healthcare Provider Details

I. General information

NPI: 1184017725
Provider Name (Legal Business Name): L AND L CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2015
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5613 LA JOYA CT
ORLANDO FL
32808-1941
US

IV. Provider business mailing address

5613 LA JOYA CT
ORLANDO FL
32808-1941
US

V. Phone/Fax

Practice location:
  • Phone: 407-701-8201
  • Fax: 800-605-5067
Mailing address:
  • Phone: 407-701-8201
  • Fax: 800-605-5067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LATREESE N JACKSON
Title or Position: MANAGING PARTNER
Credential:
Phone: 407-701-8204