Provider Demographics
NPI:1396377008
Name:OVATION HOME CARE, LLC
Entity Type:Organization
Organization Name:OVATION HOME CARE, LLC
Other - Org Name:OVATION HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-553-9723
Mailing Address - Street 1:214 W UNIVERSITY AVE STE A1
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-5685
Mailing Address - Country:US
Mailing Address - Phone:352-441-9441
Mailing Address - Fax:
Practice Address - Street 1:214 W UNIVERSITY AVE STE A1
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5685
Practice Address - Country:US
Practice Address - Phone:352-441-9441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health