Healthcare Provider Details

I. General information

NPI: 1346893773
Provider Name (Legal Business Name): SALTERS FAMILY HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2834 2ND AVE S
SAINT PETERSBURG FL
33712-1004
US

IV. Provider business mailing address

2834 2ND AVE S
SAINT PETERSBURG FL
33712-1004
US

V. Phone/Fax

Practice location:
  • Phone: 727-320-7931
  • Fax:
Mailing address:
  • Phone: 727-320-7931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIARA SALTER
Title or Position: OWNER
Credential:
Phone: 727-320-7931