Healthcare Provider Details

I. General information

NPI: 1811277874
Provider Name (Legal Business Name): SPIRIT HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2011
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8451 SHADE AVE BLDG 2, SUITE 210
SARASOTA FL
34243-2878
US

IV. Provider business mailing address

8451 SHADE AVE BLDG 2, SUITE 210
SARASOTA FL
34243-2878
US

V. Phone/Fax

Practice location:
  • Phone: 941-378-4214
  • Fax: 941-378-4216
Mailing address:
  • Phone: 941-378-4214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number30211519
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number30211519
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number30211519
License Number StateFL

VIII. Authorized Official

Name: CANDY KING
Title or Position: ADMINISTRATOR
Credential:
Phone: 941-378-4214