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General NPI Number Information
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NPI Number | 1629726807
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Entity Type | Organization
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Legal Business Name | REGINA PROVIDING CARE, INC.
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 800 VIRGINIA AVE STE 42
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City | FORT PIERCE
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State | FL
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Zip | 34982-5893
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Country | US
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Telephone | 772-323-0055
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Fax | 772-323-0142
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Provider Business Mailing Address
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Address Line | 800 VIRGINIA AVE STE 42
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City | FORT PIERCE
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State | FL
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Zip | 34982-5893
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Country | US
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Telephone | 772-323-0055
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Fax | 772-323-0142
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Authorized Official
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Title or Position | CEO/AGENCY OWNER
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Name | REGINA R. DONALDSON
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Credential |
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Telephone | 772-323-0055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 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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Taxonomy #3
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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 |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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