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General NPI Number Information
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NPI Number | 1265143192
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Entity Type | Organization
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Legal Business Name | HADASSAH HOME CARE LLC
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Dates
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Enumeration Date | 12/12/2022
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 124 E MIRACLE STRIP PKWY
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City | MARY ESTHER
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State | FL
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Zip | 32569-1988
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Country | US
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Telephone | 850-601-9710
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Fax | 850-710-9745
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Provider Business Mailing Address
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Address Line | 24 POULTON DR NW
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-4500
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Country | US
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Telephone | 850-601-9710
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Fax | 850-710-9745
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LEAH OWENS
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Credential |
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Telephone | 850-582-6717
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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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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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