Healthcare Provider Details

I. General information

NPI: 1356301121
Provider Name (Legal Business Name): WHITE ROSE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8368 CAMPHOR DR
SPRING HILL FL
34606-6831
US

IV. Provider business mailing address

8368 CAMPHOR DR
SPRING HILL FL
34606-6831
US

V. Phone/Fax

Practice location:
  • Phone: 352-684-8965
  • Fax: 352-684-3990
Mailing address:
  • Phone: 352-684-8965
  • Fax: 352-684-3990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberF001
License Number StateFL

VIII. Authorized Official

Name: MS. CAROLYN JANE RIVERA
Title or Position: OWNER
Credential:
Phone: 352-684-8965