=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568136810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DEVOTED HANDS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/02/2021
-----------------------------------------------------
Last Update Date | 08/02/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1717 N PINE AVE
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34475-9046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-588-0177
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14422 SHORESIDE WAY STE 110-135
-----------------------------------------------------
City | WINTER GARDEN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34787-4938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | SAMANTHA COSTA-LANTIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-588-0177
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------