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General NPI Number Information
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NPI Number | 1780990853
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Entity Type | Organization
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Legal Business Name | TAKE CARE OF MANATEE
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 6146 STATE ROAD 70 E
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City | BRADENTON
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State | FL
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Zip | 34203-9707
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Country | US
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Telephone | 941-752-7500
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Fax | 941-752-1661
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Provider Business Mailing Address
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Address Line | 6146 STATE ROAD 70 E
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City | BRADENTON
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State | FL
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Zip | 34203-9707
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Country | US
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Telephone | 941-752-7500
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Fax | 941-752-1661
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Authorized Official
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Title or Position | EXECUTIVE ADMINISTRATOR/OWNER
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Name | MRS. SUSANNE WISE
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Credential | R.N.
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Telephone | 941-752-7500
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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 | 299991405
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License Number State | FL
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