MEDICARE: CAREING FAMILY 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	261QD1600X	Developmental Disabilities Clinic/Center
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	32969	OTHER	FL	AHCA/CERTIFICATE
3	238658	OTHER	FL	AHCA/LICENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922753409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREING FAMILY LLC

Provider Business Mailing Address
First Line	:	5032 RIVER LAKE RD
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-2951
Country	:	US
Telephone Number	:	863-595-6212
Fax Number	:

Provider Business Practice Location Address
First Line	:	5032 RIVER LAKE RD
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-2951
Country	:	US
Telephone Number	:	863-595-6212
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LILLIE TIDWELL
Credential	:
Telephone Number	:	863-595-6212

Provider Enumeration Date	:	02/14/2022
Last Update Date	:	07/13/2023

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Directions to “CAREING FAMILY LLC ” Practice Location

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