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General NPI Number Information
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NPI Number | 1124210158
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Entity Type | Organization
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Legal Business Name | MARANATHA HOME CARE, INC.
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 10/30/2009
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Provider Practice Location Address
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Address Line | 1164 GOODLETTE ROAD
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City | NAPLES
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State | FL
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Zip | 34102
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Country | US
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Telephone | 239-659-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 360 HAMILTON AVE SUITE 120
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City | WHITE PLAINS
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State | NY
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Zip | 10601-1811
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Country | US
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Telephone | 914-428-7722
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. GREGORY TURCHAN
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Credential | MSW, MPA
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Telephone | 914-428-7722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 20737096
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 20737096
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License Number State | FL
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