=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902732183
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLUE WAVE COMPANION CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2026
-----------------------------------------------------
Last Update Date | 06/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3249 ROCK ROYAL DR
-----------------------------------------------------
City | HOLIDAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34691-1048
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-404-0800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3249 ROCK ROYAL DR
-----------------------------------------------------
City | HOLIDAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34691-1048
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-404-0800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | KELSEY SCHARFF
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 865-404-0800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------