Provider Demographics
NPI:1609116052
Name:EASY CARE LIVING COMPANION& HOME HEALTH AGENCY. INC
Entity Type:Organization
Organization Name:EASY CARE LIVING COMPANION& HOME HEALTH AGENCY. INC
Other - Org Name:EASY CARE LIVING COMPANION & HOME HEALTH AGENCY. INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIANA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:KIMBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-667-4592
Mailing Address - Street 1:687 69TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-6245
Mailing Address - Country:US
Mailing Address - Phone:727-667-4592
Mailing Address - Fax:
Practice Address - Street 1:687 69TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-6245
Practice Address - Country:US
Practice Address - Phone:727-667-4592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health