Provider Demographics
NPI:1417253691
Name:EMERALD COAST PERSONAL CARE
Entity Type:Organization
Organization Name:EMERALD COAST PERSONAL CARE
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-297-1897
Mailing Address - Street 1:PO BOX 14924
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-4924
Mailing Address - Country:US
Mailing Address - Phone:850-297-1897
Mailing Address - Fax:850-216-0470
Practice Address - Street 1:2528 BARRINGTON CIR # 2
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-3888
Practice Address - Country:US
Practice Address - Phone:850-297-1897
Practice Address - Fax:850-216-0470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992624251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health