Healthcare Provider Details

I. General information

NPI: 1922404680
Provider Name (Legal Business Name): VENICE HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2014
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 E VENICE AVE STE 201
VENICE FL
34292
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 941-218-5427
  • Fax: 941-218-5428
Mailing address:
  • Phone: 800-489-1307
  • Fax: 337-233-5764

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: JOSHUA PROFFITT
Title or Position: TREASURER
Credential:
Phone: 337-233-1307