Healthcare Provider Details

I. General information

NPI: 1801990429
Provider Name (Legal Business Name): ADVENTHEALTH HOME HEALTH AND HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 W GRANADA BLVD STE 304
ORMOND BEACH FL
32174-5180
US

IV. Provider business mailing address

770 W GRANADA BLVD STE 304
ORMOND BEACH FL
32174-5180
US

V. Phone/Fax

Practice location:
  • Phone: 386-671-2138
  • Fax: 386-672-0314
Mailing address:
  • Phone: 386-671-2138
  • Fax: 386-672-0314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number5039096
License Number StateFL

VIII. Authorized Official

Name: MARK WHEELER
Title or Position: CFO
Credential:
Phone: 530-545-1409