Provider Demographics
NPI:1447589627
Name:THE HOMECARE TEAM LLC
Entity Type:Organization
Organization Name:THE HOMECARE TEAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-476-3416
Mailing Address - Street 1:16203 BELLE MEADE BLVD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-3334
Mailing Address - Country:US
Mailing Address - Phone:813-476-3416
Mailing Address - Fax:
Practice Address - Street 1:3750 GUNN HWY STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-8911
Practice Address - Country:US
Practice Address - Phone:813-476-3416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992908251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299992908OtherHOME HEALTH AGENCY LIC NUMBER