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General NPI Number Information
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NPI Number | 1285131664
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Entity Type | Organization
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Legal Business Name | CALVARY HOME HEALTH AGENCY
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Dates
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Enumeration Date | 04/11/2018
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Last Update Date | 04/11/2018
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Provider Practice Location Address
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Address Line | 130 S INDIAN RIVER DR STE 202
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City | FORT PIERCE
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State | FL
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Zip | 34950-4353
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Country | US
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Telephone | 772-497-5930
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Fax |
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Provider Business Mailing Address
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Address Line | 130 S INDIAN RIVER DR STE 202
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City | FORT PIERCE
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State | FL
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Zip | 34950-4353
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Country | US
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Telephone | 561-409-0819
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CHRISTINE MARIE COMMOND
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Credential |
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Telephone | 772-497-5930
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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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