Provider Demographics
NPI:1184661993
Name:COMPREHENSIVE HOME CARE OF HILLSBOROUGH, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE HOME CARE OF HILLSBOROUGH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-834-2222
Mailing Address - Street 1:33920 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 341
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2654
Mailing Address - Country:US
Mailing Address - Phone:727-786-5520
Mailing Address - Fax:
Practice Address - Street 1:3102 W WATERS AVE
Practice Address - Street 2:SUITE 202A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2875
Practice Address - Country:US
Practice Address - Phone:813-514-5520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE WELLNESS SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-01
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991972251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108136Medicare Oscar/Certification