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General NPI Number Information
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NPI Number | 1003634924
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Entity Type | Organization
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Legal Business Name | COMPASSUS BSMH ST. PETERSBURG HHA I, LLC
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 137 S PEBBLE BEACH BLVD STE 203
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5708
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Country | US
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Telephone | 813-443-5566
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Fax | 813-374-6997
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Provider Business Mailing Address
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Address Line | 10 CADILLAC DR STE 400
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City | BRENTWOOD
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State | TN
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Zip | 37027-1001
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Country | US
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Telephone | 615-637-9163
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Fax | 615-373-4457
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Authorized Official
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Title or Position | SVP, CHIEF LEGAL OFFICER
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Name | RUSSELL ADKINS
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Credential |
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Telephone | 615-926-0340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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