MEDICARE: MONUMENT HOME CARE 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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1831031293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONUMENT HOME CARE LLC

Provider Business Mailing Address
First Line	:	808 E NORFOLK ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-4939
Country	:	US
Telephone Number	:	813-484-7713
Fax Number	:

Provider Business Practice Location Address
First Line	:	4203 N SEMINOLE AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-3847
Country	:	US
Telephone Number	:	813-484-7713
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JASON PARENT
Credential	:
Telephone Number	:	813-484-7713

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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