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General NPI Number Information
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NPI Number | 1114486156
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Entity Type | Organization
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Legal Business Name | NETTIE'S LOVE & CARE LLC
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 901 NW 8TH AVE STE A2-R2
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City | GAINESVILLE
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State | FL
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Zip | 32601-5011
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Country | US
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Telephone | 352-258-3450
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 358774
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City | GAINESVILLE
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State | FL
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Zip | 32635-8774
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Country | US
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Telephone | 352-258-3450
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Fax | 352-373-7818
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Authorized Official
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Title or Position | CEO/ OWNER
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Name | TANDRA LAMIKIA SIMMONS
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Credential |
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Telephone | 352-258-3450
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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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