Provider Demographics
NPI:1396378154
Name:CRADLE OF LOVE HOMEMAKER AND COMPANION SERVICES
Entity Type:Organization
Organization Name:CRADLE OF LOVE HOMEMAKER AND COMPANION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLENE
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-640-6291
Mailing Address - Street 1:18808 SUNTERRA DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-2625
Mailing Address - Country:US
Mailing Address - Phone:813-640-6293
Mailing Address - Fax:
Practice Address - Street 1:301 CHASTAIN RD
Practice Address - Street 2:
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-4803
Practice Address - Country:US
Practice Address - Phone:813-640-6293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health