Provider Demographics
NPI:1518419977
Name:PRINCETON HOMECARE SERVICES, LLC
Entity Type:Organization
Organization Name:PRINCETON HOMECARE SERVICES, LLC
Other - Org Name:ADVENTHEALTH HOME CARE CENTRAL FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIELD ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:CORA
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-691-8205
Mailing Address - Street 1:602 COURTLAND ST STE 310
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-1341
Mailing Address - Country:US
Mailing Address - Phone:407-691-8205
Mailing Address - Fax:
Practice Address - Street 1:602 COURTLAND STREET
Practice Address - Street 2:SUITE 310
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1332
Practice Address - Country:US
Practice Address - Phone:407-691-8205
Practice Address - Fax:407-691-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health