=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043757008
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAFER AT HOME LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2017
-----------------------------------------------------
Last Update Date | 10/13/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8630 E COUNTY ROAD 466 STE A
-----------------------------------------------------
City | THE VILLAGES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32162-5614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-633-4270
-----------------------------------------------------
Fax | 352-600-3505
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8564 E COUNTY ROAD 466 STE 303
-----------------------------------------------------
City | THE VILLAGES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32162-3021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 844-997-2337
-----------------------------------------------------
Fax | 855-450-1323
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | JONAS WOIKE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 352-633-4270
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 30211778
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------