Healthcare Provider Details
I. General information
NPI: 1598561706
Provider Name (Legal Business Name): PCAH HERNANDO CARES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5172 MARINER BLVD # 100
SPRING HILL FL
34609-1802
US
IV. Provider business mailing address
511 PAINTED LEAF DR
BROOKSVILLE FL
34604-1463
US
V. Phone/Fax
- Phone: 727-271-1328
- Fax:
- Phone: 727-271-1328
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADAM
LEROUX
Title or Position: CEO
Credential:
Phone: 727-271-1328