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General NPI Number Information
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NPI Number | 1477089597
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Entity Type | Organization
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Legal Business Name | PLAN LIFE CARE LLC
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 601 INNOVATION WAY
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City | DAYTONA BEACH
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State | FL
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Zip | 32114
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Country | US
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Telephone | 386-968-1920
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Fax | 954-900-1630
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Provider Business Mailing Address
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Address Line | 601 INNOVATION WAY
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-3865
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Country | US
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Telephone | 386-968-1920
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Fax | 954-900-1630
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Authorized Official
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Title or Position | OWNER
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Name | ANTHONY FRANK WILLIAM FORD
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Credential |
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Telephone | 386-986-1920
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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 | 299994708
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License Number State | FL
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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 | 234761
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 299994708
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License Number State | FL
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