Healthcare Provider Details

I. General information

NPI: 1114534476
Provider Name (Legal Business Name): CTC'S HEART OF CARING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2995 EAGLE NEST VIEW DRIVE
WINTER HAVEN FL
33881
US

IV. Provider business mailing address

2995 EAGLE NEST VIEW DRIVE
WINTER HAVEN FL
33881
US

V. Phone/Fax

Practice location:
  • Phone: 863-514-7501
  • Fax:
Mailing address:
  • Phone: 863-514-7501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MISS CHRISANA LATAI SCOTT
Title or Position: OWNER
Credential:
Phone: 863-514-7501