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General NPI Number Information
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NPI Number | 1407308471
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Entity Type | Organization
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Legal Business Name | CRITERION HOMECARE, INC.
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 235 S MAITLAND AVE SUITE 107
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City | MAITLAND
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State | FL
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Zip | 32751-5677
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Country | US
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Telephone | 407-622-0801
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Fax |
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Provider Business Mailing Address
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Address Line | 235 S MAITLAND AVE SUITE 107
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City | MAITLAND
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State | FL
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Zip | 32751-5677
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Country | US
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Telephone | 407-622-0801
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES FRANCIS CLANCY
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Credential | ARNP
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Telephone | 407-622-0801
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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 | 299994571
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License Number State | FL
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