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General NPI Number Information
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NPI Number | 1912549114
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Entity Type | Organization
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Legal Business Name | HOMETOWN HOME HEALTH LLC
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Dates
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Enumeration Date | 10/09/2019
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 421 S 6TH ST
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City | MACCLENNY
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State | FL
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Zip | 32063-2319
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Country | US
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Telephone | 904-259-2273
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Fax | 904-717-8810
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Provider Business Mailing Address
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Address Line | 421 S 6TH ST
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City | MACCLENNY
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State | FL
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Zip | 32063-2319
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Country | US
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Telephone | 904-259-2273
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Fax | 904-717-8810
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Authorized Official
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Title or Position | OWNER
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Name | MATTI LEE
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Credential | RN
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Telephone | 904-755-2113
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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 |
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License Number State |
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Taxonomy #2
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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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