Healthcare Provider Details

I. General information

NPI: 1639630726
Provider Name (Legal Business Name): E & N COMPANION CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 SW MONTEREY RD
STUART FL
34994-4610
US

IV. Provider business mailing address

130 SW MONTEREY RD
STUART FL
34994-4610
US

V. Phone/Fax

Practice location:
  • Phone: 772-287-5432
  • Fax: 772-497-7012
Mailing address:
  • Phone: 772-287-5432
  • Fax: 772-497-7012

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: DANIEL BENTANCUR
Title or Position: ADMINISTRATOR
Credential:
Phone: 772-287-5432