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General NPI Number Information
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NPI Number | 1730623307
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Entity Type | Organization
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Legal Business Name | HARMONY SENIOR SERVICE INC
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Dates
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Enumeration Date | 12/15/2016
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Last Update Date | 12/15/2016
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Provider Practice Location Address
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Address Line | 809 PEARL ST
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-9542
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Country | US
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Telephone | 904-844-1467
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 754 2120 U.S 1 SOUTH SUITE 112
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City | ST AUGUSTINE
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State | FL
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Zip | 32085-0754
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Country | US
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Telephone | 904-844-1467
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TANYA BOATWRIGHT
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Credential |
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Telephone | 904-844-1467
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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 | 234434
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License Number State | FL
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