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General NPI Number Information
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NPI Number | 1730941931
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Entity Type | Organization
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Legal Business Name | SLC AT HOME CARES, LLC
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 2113 CITRUS BLVD STE B
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City | LEESBURG
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State | FL
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Zip | 34748-3018
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Country | US
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Telephone | 352-630-9879
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Fax |
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Provider Business Mailing Address
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Address Line | 108 SUE LN
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City | LADY LAKE
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State | FL
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Zip | 32159-4395
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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 | OWNER
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Name | DENISE GRAHAM
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Credential |
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Telephone | 352-630-9879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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