Provider Demographics
NPI:1568824985
Name:AGING IN PLACE HOME CARE,LLC
Entity Type:Organization
Organization Name:AGING IN PLACE HOME CARE,LLC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DREW
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-375-8400
Mailing Address - Street 1:141 POND CYPRESS RD STE A
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1736
Mailing Address - Country:US
Mailing Address - Phone:941-375-8400
Mailing Address - Fax:941-375-8409
Practice Address - Street 1:141 POND CYPRESS RD STE A
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1736
Practice Address - Country:US
Practice Address - Phone:941-375-8400
Practice Address - Fax:941-375-8409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994029251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008840200Medicaid