Provider Demographics
NPI:1124218300
Name:CHANGING TIDES HOME HEALTH, INC.
Entity Type:Organization
Organization Name:CHANGING TIDES HOME HEALTH, INC.
Other - Org Name:COMPREHENSIVE HOME CARE OF SW FL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-461-9009
Mailing Address - Street 1:5582 BROADCAST CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8471
Mailing Address - Country:US
Mailing Address - Phone:941-504-0164
Mailing Address - Fax:
Practice Address - Street 1:5582 BROADCAST CT
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-8471
Practice Address - Country:US
Practice Address - Phone:941-504-0164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991873251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108054Medicare PIN