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General NPI Number Information
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NPI Number | 1598265050
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Entity Type | Organization
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Legal Business Name | MORE LIFE HOME CARE LLC
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 113 S MAGNOLIA AVE STE 206
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City | SANFORD
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State | FL
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Zip | 32771-1307
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Country | US
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Telephone | 321-363-0980
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Fax | 313-672-6422
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Provider Business Mailing Address
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Address Line | 113 S MAGNOLIA AVE STE 206
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City | SANFORD
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State | FL
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Zip | 32771-1307
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Country | US
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Telephone | 321-363-0980
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Fax | 313-672-6422
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. CHARLES EDMUND GRAVES III
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Credential | CSCM
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Telephone | 321-363-0980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | FL
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