Provider Demographics
NPI:1073905832
Name:OPTIMAL PATIENT CARE OF THE NATURE COAST LLC
Entity Type:Organization
Organization Name:OPTIMAL PATIENT CARE OF THE NATURE COAST LLC
Other - Org Name:REHAB AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:BARLAAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-918-0611
Mailing Address - Street 1:1310 - 3 NORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748
Mailing Address - Country:US
Mailing Address - Phone:352-414-5901
Mailing Address - Fax:352-493-9682
Practice Address - Street 1:1310 - 3 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748
Practice Address - Country:US
Practice Address - Phone:352-414-5901
Practice Address - Fax:352-493-9682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993072251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299993072OtherAHCA FLORIDA HOME HEALTH LICENSE