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General NPI Number Information
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NPI Number | 1194157180
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Entity Type | Organization
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Legal Business Name | HANSON SERVICES. NO. 5, INC.
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 1601 RICKENBACKER DR #5
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5332
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Country | US
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Telephone | 813-634-6617
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Fax | 813-634-7259
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Provider Business Mailing Address
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Address Line | 1601 RICKENBACKER DR #5
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5332
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Country | US
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Telephone | 813-634-6617
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Fax | 813-634-7259
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. ANNA GRACE LEININGER
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Credential |
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Telephone | 239-357-7243
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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 | 30211040
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License Number State | FL
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