=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083570964
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRANNYS IN HOME CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2026
-----------------------------------------------------
Last Update Date | 01/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4415 FLORIDA NATIONAL DR STE 201
-----------------------------------------------------
City | LAKELAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33813-1569
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-808-3533
-----------------------------------------------------
Fax | 863-644-9194
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4415 FLORIDA NATIONAL DR STE 201
-----------------------------------------------------
City | LAKELAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33813-1569
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-808-3533
-----------------------------------------------------
Fax | 863-644-9194
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. NECOLE JAVAN DULING
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 863-808-3533
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------