Provider Demographics
NPI:1114615143
Name:INNOVATION HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:INNOVATION HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KALAISENTHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-663-9955
Mailing Address - Street 1:7733 W NEWBERRY RD STE B2
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-9245
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7733 W NEWBERRY RD STE B2
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-9245
Practice Address - Country:US
Practice Address - Phone:352-663-9955
Practice Address - Fax:352-663-8877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health