MEDICARE: ANN'S HOUSE, INC.

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	310400000X	Assisted Living Facility	11242	FL

General Provider Information

NPI Number	:	1982015145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANN'S HOUSE, INC.

Provider Business Mailing Address
First Line	:	6240 BRISTOL LN
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-1230
Country	:	US
Telephone Number	:	352-556-5357
Fax Number	:

Provider Business Practice Location Address
First Line	:	4407 MILLWOOD RD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34608-3639
Country	:	US
Telephone Number	:	352-556-5357
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ANN-MARIE RIMPLE
Credential	:
Telephone Number	:	352-206-1653

Provider Enumeration Date	:	05/09/2014
Last Update Date	:	01/26/2015

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