Provider Demographics
NPI:1073246120
Name:DYNAMIC HOME HEALTH CARE SERVICE LLC
Entity Type:Organization
Organization Name:DYNAMIC HOME HEALTH CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARSHA
Authorized Official - Middle Name:YOLANDER
Authorized Official - Last Name:SEAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-669-5106
Mailing Address - Street 1:837 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4224
Mailing Address - Country:US
Mailing Address - Phone:863-669-5106
Mailing Address - Fax:
Practice Address - Street 1:837 W 2ND ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4224
Practice Address - Country:US
Practice Address - Phone:863-669-5106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services