=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477274199
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEAT COMPANION CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2022
-----------------------------------------------------
Last Update Date | 04/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 121 N FLORIDA AVE STE D
-----------------------------------------------------
City | INVERNESS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34453-1621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-656-7138
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 444
-----------------------------------------------------
City | WILDWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34785-0444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-656-7138
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. TIFFANIE WALTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 727-656-7138
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------