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General NPI Number Information
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NPI Number | 1851552855
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Entity Type | Organization
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Legal Business Name | SAMUELSON PERSONAL CARE LLC
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 1411 NE 22ND AVE
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City | OCALA
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State | FL
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Zip | 34470-7733
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Country | US
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Telephone | 352-622-6447
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Fax | 352-622-5578
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Provider Business Mailing Address
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Address Line | 1411 NE 22ND AVE
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City | OCALA
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State | FL
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Zip | 34470-7733
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Country | US
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Telephone | 352-622-6447
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Fax | 352-622-5578
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Authorized Official
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Title or Position | FRANCHISE OWNER
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Name | MR. JIM SAMUELSON
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Credential |
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Telephone | 352-622-6447
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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 | 299993167
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License Number State | FL
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