Healthcare Provider Details

I. General information

NPI: 1225402092
Provider Name (Legal Business Name): NURTURING CARE COMPANIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2015
Last Update Date: 01/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 58TH AVE N
ST PETERSBURG FL
33703-1037
US

IV. Provider business mailing address

1400 58TH AVE N
ST PETERSBURG FL
33703-1037
US

V. Phone/Fax

Practice location:
  • Phone: 727-550-6476
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MONICA L BYRD
Title or Position: PRESIDENT
Credential:
Phone: 727-550-6476