Provider Demographics
NPI:1114218674
Name:HOME CARE CONNECT
Entity Type:Organization
Organization Name:HOME CARE CONNECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VONESA
Authorized Official - Middle Name:W
Authorized Official - Last Name:WENZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-223-2228
Mailing Address - Street 1:507 N NEW YORK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3143
Mailing Address - Country:US
Mailing Address - Phone:855-223-2228
Mailing Address - Fax:855-518-5453
Practice Address - Street 1:507 N NEW YORK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3143
Practice Address - Country:US
Practice Address - Phone:855-223-2228
Practice Address - Fax:855-518-5453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service