Healthcare Provider Details

I. General information

NPI: 1942872536
Provider Name (Legal Business Name): PT FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 16TH ST W
PALMETTO FL
34221-3926
US

IV. Provider business mailing address

PO BOX 352
ELLENTON FL
34222-0352
US

V. Phone/Fax

Practice location:
  • Phone: 941-545-6823
  • Fax:
Mailing address:
  • Phone: 209-815-8468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MARCY HARRIS
Title or Position: PRESIDENT
Credential:
Phone: 209-815-8468