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General NPI Number Information
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NPI Number | 1619544632
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Entity Type | Organization
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Legal Business Name | RIVERBEAR HOMECARE LLC
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 2701 REGENCY OAKS BLVD
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City | CLEARWATER
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State | FL
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Zip | 33759-1526
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Country | US
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Telephone | 727-288-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 9355 113TH ST UNIT 7935
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City | SEMINOLE
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State | FL
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Zip | 33775-6914
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Country | US
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Telephone | 727-288-2345
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MARY JO OSORIO
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Credential | CNA
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Telephone | 727-288-2345
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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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