Provider Demographics
NPI:1003384447
Name:RELY ON US HOME CARE, LLC
Entity Type:Organization
Organization Name:RELY ON US HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-735-6847
Mailing Address - Street 1:PO BOX 1793
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33568-1793
Mailing Address - Country:US
Mailing Address - Phone:813-735-6847
Mailing Address - Fax:
Practice Address - Street 1:10103 SHERWOOD LN APT 67
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-3640
Practice Address - Country:US
Practice Address - Phone:813-735-6847
Practice Address - Fax:800-707-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-04
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102697500Medicaid
FL235676OtherAHCA LIC #