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General NPI Number Information
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NPI Number | 1104079565
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Entity Type | Organization
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Legal Business Name | HANSON SERVICES #5 INC.
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 13571 MCGREGOR BLVD SUITE 26
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City | FORT MYERS
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State | FL
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Zip | 33919-6057
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Country | US
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Telephone | 239-433-0230
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Fax | 239-437-7111
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Provider Business Mailing Address
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Address Line | 14600 DETROIT AVE STE 420 P.O. BOX 771222
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City | LAKEWOOD
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State | OH
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Zip | 44107-4299
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Country | US
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Telephone | 216-226-5425
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Fax | 216-226-5623
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ANNA LEININGER
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Credential |
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Telephone | 239-433-0230
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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 | NR30211234
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License Number State | FL
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