Healthcare Provider Details

I. General information

NPI: 1841051034
Provider Name (Legal Business Name): NORTH BAY HOME HEALTH CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13361 N 56TH ST STE E
TAMPA FL
33617-1161
US

IV. Provider business mailing address

8514 N 10TH ST
TAMPA FL
33604-1710
US

V. Phone/Fax

Practice location:
  • Phone: 336-926-0133
  • Fax:
Mailing address:
  • Phone: 336-926-0133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL BAPTISTE
Title or Position: DIRECTOR
Credential:
Phone: 336-926-0133