Provider Demographics
NPI:1437514270
Name:STANTON'S HOMECARE
Entity Type:Organization
Organization Name:STANTON'S HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:TEMPESTT
Authorized Official - Middle Name:O
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-366-7366
Mailing Address - Street 1:10371 CROSSLEY HILL DR.
Mailing Address - Street 2:
Mailing Address - City:GRANDBAY
Mailing Address - State:AL
Mailing Address - Zip Code:36541
Mailing Address - Country:US
Mailing Address - Phone:251-366-7366
Mailing Address - Fax:
Practice Address - Street 1:10371 CROSSLEY HILL DR
Practice Address - Street 2:
Practice Address - City:GRAND BAY
Practice Address - State:AL
Practice Address - Zip Code:36541-3207
Practice Address - Country:US
Practice Address - Phone:251-366-7366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL101581302R00000X, 305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization