Healthcare Provider Details

I. General information

NPI: 1861040636
Provider Name (Legal Business Name): HOUSE OF CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 IOWA LN
TALLAHASSEE FL
32305-3482
US

IV. Provider business mailing address

PO BOX 1743
QUINCY FL
32353-1743
US

V. Phone/Fax

Practice location:
  • Phone: 850-727-2555
  • Fax:
Mailing address:
  • Phone: 850-727-2555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MONICA MURRAY LIGHTFOOT
Title or Position: ADMINISTRATOR
Credential:
Phone: 850-727-2555