Provider Demographics
NPI:1487037123
Name:CASTERLINE AND CASTERLINE, INC
Entity Type:Organization
Organization Name:CASTERLINE AND CASTERLINE, INC
Other - Org Name:SYNERGY HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:407-613-2273
Mailing Address - Street 1:2200 LUCIEN WAY
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7007
Mailing Address - Country:US
Mailing Address - Phone:407-613-2273
Mailing Address - Fax:
Practice Address - Street 1:2200 LUCIEN WAY
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7007
Practice Address - Country:US
Practice Address - Phone:407-613-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233922253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care