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General NPI Number Information
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NPI Number | 1043268246
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Entity Type | Organization
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Legal Business Name | HOUSECALL SUPPORTIVE SERVICES, INC.
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 10/07/2010
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Provider Practice Location Address
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Address Line | 12601 NEW BRITTANY BLVD BUILDING 19
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City | FORT MYERS
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State | FL
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Zip | 33907-3631
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Country | US
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Telephone | 239-274-0664
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Fax | 239-275-3208
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Provider Business Mailing Address
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Address Line | 5959 S SHERWOOD FOREST BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-6038
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Country | US
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Telephone | 225-292-2031
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Fax | 225-295-9678
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Authorized Official
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Title or Position | CEO
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Name | WILLIAM BORNE
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Credential |
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Telephone | 225-292-2031
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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 | 213280962
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License Number State | FL
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