Provider Demographics
NPI:1336663764
Name:PLANTERS HOMECARE
Entity Type:Organization
Organization Name:PLANTERS HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLANTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-236-9316
Mailing Address - Street 1:12789 SW 38TH CIR
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-7801
Mailing Address - Country:US
Mailing Address - Phone:352-236-9316
Mailing Address - Fax:
Practice Address - Street 1:12789 SW 38TH CIR
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473
Practice Address - Country:US
Practice Address - Phone:352-236-9316
Practice Address - Fax:352-693-4577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-27
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X, 253Z00000X, 261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022182300Medicaid
FL021882800Medicaid
FL021400000Medicaid