Provider Demographics
NPI:1205230174
Name:CARETENDERS VISITING SERVICES OF GAINESVILLE, LLC
Entity Type:Organization
Organization Name:CARETENDERS VISITING SERVICES OF GAINESVILLE, LLC
Other - Org Name:CARETENDERS HEALTH AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIRA
Authorized Official - Middle Name:NEL
Authorized Official - Last Name:BOTES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L CHT
Authorized Official - Phone:352-359-0739
Mailing Address - Street 1:8109 NW 27TH BLVD
Mailing Address - Street 2:CARETENDERS HEALTH AND REHAB
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-8636
Mailing Address - Country:US
Mailing Address - Phone:352-792-6464
Mailing Address - Fax:352-792-6463
Practice Address - Street 1:8109 NW 27TH BLVD
Practice Address - Street 2:CARETENDERS HEALTH AND REHAB
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-8636
Practice Address - Country:US
Practice Address - Phone:352-792-6464
Practice Address - Fax:352-792-6463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC10217261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy