MEDICARE: FAMILY LINK SUPPORT SERVICE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1053030874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY LINK SUPPORT SERVICE LLC

Provider Business Mailing Address
First Line	:	2780 ANN ROU RD UNIT 2801
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-5342
Country	:	US
Telephone Number	:	352-434-2001
Fax Number	:

Provider Business Practice Location Address
First Line	:	2780 ANN ROU RD UNIT 2801
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-5342
Country	:	US
Telephone Number	:	352-434-2001
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VANESSA POLLOCK
Credential	:
Telephone Number	:	352-434-2001

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	08/24/2022

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Directions to “FAMILY LINK SUPPORT SERVICE LLC ” Practice Location

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