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General NPI Number Information
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NPI Number | 1952891244
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Entity Type | Organization
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Legal Business Name | ANSLEY HEALTH LLC
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 05/15/2018
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Provider Practice Location Address
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Address Line | 1502 6TH CT NE
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City | WINTER HAVEN
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State | FL
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Zip | 33881
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Country | US
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Telephone | 863-651-2139
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Fax |
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Provider Business Mailing Address
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Address Line | 112 WEEPING WILLOW RD
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City | EAGLE LAKE
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State | FL
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Zip | 33839-5118
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Country | US
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Telephone | 863-651-2139
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JAQUIS MCCULLOUGH
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Credential |
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Telephone | 863-651-2139
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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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