Healthcare Provider Details

I. General information

NPI: 1841576105
Provider Name (Legal Business Name): SHARE THE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2011
Last Update Date: 07/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 FORMOSA AVE
WINTER PARK FL
32789-5329
US

IV. Provider business mailing address

1524 FORMOSA AVE
WINTER PARK FL
32789-5329
US

V. Phone/Fax

Practice location:
  • Phone: 407-423-5311
  • Fax: 407-849-1495
Mailing address:
  • Phone: 407-423-5311
  • Fax: 407-849-1495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9233
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number339
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number9079
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number9298
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number347
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number9233
License Number StateFL

VIII. Authorized Official

Name: MARY ELLEN GRANT
Title or Position: CEO
Credential:
Phone: 407-423-5311