Healthcare Provider Details

I. General information

NPI: 1588343768
Provider Name (Legal Business Name): HOMECARE RESCUE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6013 WESLEY GROVE BLVD STE 202
WESLEY CHAPEL FL
33544-8424
US

IV. Provider business mailing address

6013 WESLEY GROVE BLVD STE 202
WESLEY CHAPEL FL
33544-8424
US

V. Phone/Fax

Practice location:
  • Phone: 813-599-5556
  • Fax: 888-247-7413
Mailing address:
  • Phone: 813-599-5556
  • Fax: 888-247-7413

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: JAIMAL SHELTON
Title or Position: MANAGING PARTNER
Credential:
Phone: 813-553-2048