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General NPI Number Information
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NPI Number | 1619668563
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Entity Type | Organization
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Legal Business Name | ADVANCE HOME CARE LLC
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 2309 SEVEN OAKS DR
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City | SAINT CLOUD
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State | FL
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Zip | 34772-7821
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Country | US
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Telephone | 407-868-4289
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Fax |
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Provider Business Mailing Address
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Address Line | 2309 SEVEN OAKS DR
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City | SAINT CLOUD
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State | FL
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Zip | 34772-7821
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Country | US
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Telephone | 407-868-4289
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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 | SHAWNTIA SHERICE JONES
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Credential | RN
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Telephone | 140-786-8428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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