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General NPI Number Information
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NPI Number | 1558684910
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Entity Type | Organization
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Legal Business Name | SUNCREST HOME HEALTH OF CENTRAL FL, LLC
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Dates
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Enumeration Date | 03/12/2010
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 994 DOUGLAS AVE SUITE 100
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2068
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Country | US
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Telephone | 407-328-9993
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Fax | 407-328-8227
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Provider Business Mailing Address
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Address Line | 510 HOSPITAL DR SUITE 150
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City | MADISON
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State | TN
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Zip | 37115-5033
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Country | US
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Telephone | 615-627-9267
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Fax | 615-577-0081
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Authorized Official
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Title or Position | DIRECTOR OF LICENSING/ACCREDITATION
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Name | AMANDA MCFADDIN
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Credential |
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Telephone | 615-712-2250
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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 | 299992128
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License Number State | FL
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