Provider Demographics
NPI:1437858610
Name:SERVANTS COMMUNIYT CARE, LLC.
Entity Type:Organization
Organization Name:SERVANTS COMMUNIYT CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PROVIDER
Authorized Official - Phone:772-206-6142
Mailing Address - Street 1:603 E FORT KING ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2235
Mailing Address - Country:US
Mailing Address - Phone:772-206-6142
Mailing Address - Fax:
Practice Address - Street 1:613 SILVER PASS
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-2230
Practice Address - Country:US
Practice Address - Phone:772-206-6142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging