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General NPI Number Information
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NPI Number | 1902610504
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Entity Type | Organization
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Legal Business Name | IGNITE HOME HEALTH-REGION 5 LLC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 11400 47TH ST N STE C
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City | CLEARWATER
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State | FL
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Zip | 33762-4901
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Country | US
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Telephone | 800-298-5479
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Fax |
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Provider Business Mailing Address
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Address Line | 4030 HENDERSON BLVD STE 541
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City | TAMPA
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State | FL
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Zip | 33629
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Country | US
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Telephone | 800-298-5479
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAUL T HAUSMAN
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Credential |
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Telephone | 727-409-5550
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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 |
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License Number State |
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