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General NPI Number Information
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NPI Number | 1568239812
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Entity Type | Organization
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Legal Business Name | COMPLETE HOME CARE - PRIVATE DUTY LLC
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Dates
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Enumeration Date | 12/07/2023
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 3181 N BAY VILLAGE CT STE A-201
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-7222
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Country | US
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Telephone | 941-867-7581
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Fax | 941-867-8751
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Provider Business Mailing Address
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Address Line | 5601 EXECUTIVE DR STE 250
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City | IRVING
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State | TX
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Zip | 75038-2508
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Country | US
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Telephone | 972-677-3471
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. JONATHAN FUNSTON
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Credential |
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Telephone | 706-877-0838
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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 |
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License Number State |
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