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General NPI Number Information
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NPI Number | 1447611801
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Entity Type | Organization
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Legal Business Name | FLAGLER BEACH HOMECARE
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Dates
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Enumeration Date | 03/14/2016
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 1222 S CENTRAL AVE
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-3721
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Country | US
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Telephone | 386-338-2072
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Fax |
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Provider Business Mailing Address
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Address Line | 1222 S CENTRAL AVE
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-3721
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Country | US
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Telephone | 386-338-2072
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GENA S SNEAD
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Credential | NURSE
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Telephone | 386-338-2072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | PN5181900
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PN5181900
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License Number State | FL
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