Provider Demographics
NPI:1578914990
Name:HOME INSTEAD SENIOR CARE
Entity Type:Organization
Organization Name:HOME INSTEAD SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGIOTATOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-342-6655
Mailing Address - Street 1:2411 OLD SHELL RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3019
Mailing Address - Country:US
Mailing Address - Phone:251-342-6655
Mailing Address - Fax:
Practice Address - Street 1:2411 OLD SHELL RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3019
Practice Address - Country:US
Practice Address - Phone:251-342-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL060745253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care