=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972701183
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME HEALTH CONNECTION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2007
-----------------------------------------------------
Last Update Date | 06/12/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24160 STATE ROAD 54 STE 5
-----------------------------------------------------
City | LUTZ
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33559-6766
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-994-7826
-----------------------------------------------------
Fax | 813-994-8035
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24160 STATE ROAD 54 STE 5
-----------------------------------------------------
City | LUTZ
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33559-6766
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-994-7826
-----------------------------------------------------
Fax | 813-994-8035
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | JULIE LIVERINGHOUSE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 612-378-1474
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 299992805
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------