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General NPI Number Information
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NPI Number | 1780406462
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Entity Type | Organization
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Legal Business Name | AT HOME KIDS CARE, LLC
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 740 GRAND CANAL DR
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City | POINCIANA
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State | FL
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Zip | 34759-4361
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Country | US
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Telephone | 689-238-6315
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 580421
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City | KISSIMMEE
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State | FL
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Zip | 34758-0006
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Country | US
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Telephone | 689-238-6315
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Fax |
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | MS. BRIANA BROWN
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Credential |
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Telephone | 689-238-6315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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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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