Provider Demographics
NPI:1043637226
Name:HOME HEALTH
Entity Type:Organization
Organization Name:HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSING ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:941-527-9568
Mailing Address - Street 1:2602 RIVER PRESERVE CT
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-7465
Mailing Address - Country:US
Mailing Address - Phone:941-527-9568
Mailing Address - Fax:
Practice Address - Street 1:2602 RIVER PRESERVE CT
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-7465
Practice Address - Country:US
Practice Address - Phone:941-527-9568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA 113079332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals