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General NPI Number Information
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NPI Number | 1922712801
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Entity Type | Organization
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Legal Business Name | RL HEALTHCARE LLC
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 2425 MISSION RD APT 1603
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City | TALLAHASSEE
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State | FL
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Zip | 32304-2604
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Country | US
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Telephone | 850-408-5713
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 W PENSACOLA ST STE 100 #2020
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City | TALLAHASSEE
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State | FL
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Zip | 32304-0503
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/AUTHORIZED AGENT/CAREGIVER
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Name | REVA HICKS
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Credential |
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Telephone | 850-408-5713
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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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