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General NPI Number Information
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NPI Number | 1750074910
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Entity Type | Organization
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Legal Business Name | HEART'S DESIRE HOMEMAKER & COMPANION SERVICES, LLC
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 333 3RD AVE N # 200B
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-3899
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Country | US
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Telephone | 813-735-8065
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Fax | 727-202-7331
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Provider Business Mailing Address
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Address Line | 333 3RD AVE N # 200B
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-3899
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Country | US
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Telephone | 813-735-8065
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Fax | 727-202-7331
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ADREIKA V FLUELLEN
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Credential |
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Telephone | 813-735-8065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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