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General NPI Number Information
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NPI Number | 1679953590
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Entity Type | Organization
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Legal Business Name | NEXT DOOR D3 HOLDINGS LLC
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 06/05/2015
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Provider Practice Location Address
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Address Line | 2405 HWY 27/441 BLDG. 2
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City | FRUITLAND PARK
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State | FL
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Zip | 34731-2138
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Country | US
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Telephone | 352-365-6344
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Fax | 352-365-6346
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Provider Business Mailing Address
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Address Line | 2405 HWY 27/441 BLDG. 2
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City | FRUITLAND PARK
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State | FL
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Zip | 34731-2138
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Country | US
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Telephone | 352-365-6344
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Fax | 352-365-6346
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SHELLEY LYNN ANGELL
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Credential | RN
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Telephone | 352-365-6344
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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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