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General NPI Number Information
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NPI Number | 1801342217
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Entity Type | Organization
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Legal Business Name | AEGIS HOMEMAKING, COMPANION & CHORE SERVICE OF VOLUSIA COUNTY
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Dates
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Enumeration Date | 08/27/2016
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 357 FOGGY LN
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City | PORT ORANGE
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State | FL
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Zip | 32129-7812
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Country | US
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Telephone | 518-331-3733
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Fax |
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Provider Business Mailing Address
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Address Line | 357 FOGGY LN
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City | PORT ORANGE
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State | FL
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Zip | 32129-7812
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Country | US
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Telephone | 518-331-3733
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA MCKERN
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Credential |
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Telephone | 518-331-3733
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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 | 234553
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number | 234553
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 234553
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License Number State | FL
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