=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730807694
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | F & T SENIOR COMFORT CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2022
-----------------------------------------------------
Last Update Date | 08/17/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 S AUSTRALIAN AVE STE 500
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33401-6206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-244-2558
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 326
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33402-0326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-324-0235
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ELIZABETH L NELSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 772-324-0235
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------