Provider Demographics
NPI:1578126348
Name:ST PETE CARE AT HOME LLC
Entity Type:Organization
Organization Name:ST PETE CARE AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-440-3637
Mailing Address - Street 1:111 2ND AVE NE STE 325
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3464
Mailing Address - Country:US
Mailing Address - Phone:727-440-3637
Mailing Address - Fax:
Practice Address - Street 1:111 2ND AVE NE STE 325
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3464
Practice Address - Country:US
Practice Address - Phone:727-440-3637
Practice Address - Fax:727-469-3554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health