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General NPI Number Information
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NPI Number | 1235670308
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Entity Type | Organization
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Legal Business Name | TREASURE COAST COMPASSIONATE CARE
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 2732 CARDINAL DR
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City | VERO BEACH
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State | FL
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Zip | 32963-2066
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Country | US
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Telephone | 772-501-3151
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Fax |
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Provider Business Mailing Address
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Address Line | 2732 CARDINAL DR
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City | VERO BEACH
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State | FL
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Zip | 32963-2066
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Country | US
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Telephone | 772-501-3151
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JENNIFER KIRSTEN TOBY
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Credential | RMA
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Telephone | 772-501-3151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | L16000167112
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License Number State | FL
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