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General NPI Number Information
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NPI Number | 1710656376
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Entity Type | Organization
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Legal Business Name | EVERGREEN PRIVATE CARE OF NORTH CENTRAL FLORIDA, LLC
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 3003 SW COLLEGE RD STE 109
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City | OCALA
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State | FL
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Zip | 34474-6253
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Country | US
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Telephone | 772-080-1818
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1187
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City | HOBE SOUND
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State | FL
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Zip | 33475-1187
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | WILLIAM DAVID SNYDER
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Credential |
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Telephone | 772-801-8181
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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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