Healthcare Provider Details

I. General information

NPI: 1801248380
Provider Name (Legal Business Name): SN HOME HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10853 BOYETTE RD
RIVERVIEW FL
33569-8012
US

IV. Provider business mailing address

6760 OLD JACKSONVILLE HWY STE 101
TYLER TX
75703-0566
US

V. Phone/Fax

Practice location:
  • Phone: 813-606-4177
  • Fax:
Mailing address:
  • Phone: 855-485-8273
  • Fax: 817-326-2436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299994505
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KATRINA LANIER
Title or Position: SECRETARY
Credential:
Phone: 855-485-8273