Provider Demographics
NPI:1518247469
Name:VOLUSIA-FLAGLER CAREGIVERS, INC.
Entity Type:Organization
Organization Name:VOLUSIA-FLAGLER CAREGIVERS, INC.
Other - Org Name:HOMEWATCH CAREGIVERS, LAKE MARY/SANFORD AREA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PRINGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-253-8825
Mailing Address - Street 1:3551 W LAKE MARY BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3460
Mailing Address - Country:US
Mailing Address - Phone:407-732-2402
Mailing Address - Fax:888-685-8898
Practice Address - Street 1:3551 W LAKE MARY BLVD STE 209
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3460
Practice Address - Country:US
Practice Address - Phone:407-732-2402
Practice Address - Fax:888-685-8898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VOLUSIA-FLAGLER CAREGIVERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL(PENDING)253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care