Provider Demographics
NPI:1598200024
Name:MTD GALAXY LLC.
Entity Type:Organization
Organization Name:MTD GALAXY LLC.
Other - Org Name:MY PASSION HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-970-2341
Mailing Address - Street 1:6619 CRISTINA MARIE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5751
Mailing Address - Country:US
Mailing Address - Phone:407-970-2341
Mailing Address - Fax:
Practice Address - Street 1:6619 CRISTINA MARIE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5751
Practice Address - Country:US
Practice Address - Phone:407-970-2341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care