Provider Demographics
NPI:1598265050
Name:MORE LIFE HOME CARE LLC
Entity Type:Organization
Organization Name:MORE LIFE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDMUND
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:III
Authorized Official - Credentials:CSCM
Authorized Official - Phone:321-363-0980
Mailing Address - Street 1:113 S MAGNOLIA AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1307
Mailing Address - Country:US
Mailing Address - Phone:321-363-0980
Mailing Address - Fax:313-672-6422
Practice Address - Street 1:113 S MAGNOLIA AVE STE 206
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1307
Practice Address - Country:US
Practice Address - Phone:321-363-0980
Practice Address - Fax:313-672-6422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care