Healthcare Provider Details

I. General information

NPI: 1205225398
Provider Name (Legal Business Name): YOUR HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4751 LAKEVIEW DR SUITE A
SEBRING FL
33870-2064
US

IV. Provider business mailing address

4751 LAKEVIEW DR SUITE A
SEBRING FL
33870-2064
US

V. Phone/Fax

Practice location:
  • Phone: 863-273-2284
  • Fax: 863-402-5602
Mailing address:
  • Phone: 863-273-2284
  • Fax: 863-402-5602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN AUSTIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 863-273-2284