MEDICARE: EMPYREAN HOME CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	251J00000X	Nursing Care Agency
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1508643941
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPYREAN HOME CARE LLC

Provider Business Mailing Address
First Line	:	2719 LETAP CT STE 1A
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-7286
Country	:	US
Telephone Number	:	352-806-8030
Fax Number	:	888-203-2144

Provider Business Practice Location Address
First Line	:	2719 LETAP CT STE 1A
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-7286
Country	:	US
Telephone Number	:	352-806-8030
Fax Number	:	888-203-2144

Authorized Official
Title or Position	:	OWNER
Name	:	KIM CHARLESTON
Credential	:
Telephone Number	:	352-806-8030

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	02/18/2026

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