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General NPI Number Information
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NPI Number | 1346850377
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Entity Type | Organization
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Legal Business Name | NANA'S HOME CARE, INC.
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 2090 SE RAINIER RD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-7612
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Country | US
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Telephone | 561-666-0049
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Fax |
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Provider Business Mailing Address
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Address Line | 2090 SE RAINIER RD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-7612
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Country | US
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Telephone | 561-666-0049
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MACDALIE AUMOITHE
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Credential | CNA
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Telephone | 561-666-0049
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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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