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General NPI Number Information
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NPI Number | 1871841965
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Entity Type | Organization
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Legal Business Name | NORTHWEST FLORIDA HOME CARE, INC.
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Dates
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Enumeration Date | 08/21/2012
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Last Update Date | 08/21/2012
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Provider Practice Location Address
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Address Line | 141 MACK BAYOU LOOP STE 303
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-7194
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Country | US
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Telephone | 850-687-3965
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Fax |
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Provider Business Mailing Address
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Address Line | 141 MACK BAYOU LOOP STE 303
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-7194
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Country | US
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Telephone | 850-687-3965
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | ARCHIE DALE DALBEY
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Credential |
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Telephone | 850-687-3965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 299994036
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License Number State | FL
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