Provider Demographics
NPI:1609387620
Name:SDX HOME CARE OPERATIONS, LLC
Entity Type:Organization
Organization Name:SDX HOME CARE OPERATIONS, LLC
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:AZANKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-621-9649
Mailing Address - Street 1:981 DEL MAR DR
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-7734
Mailing Address - Country:US
Mailing Address - Phone:352-221-9583
Mailing Address - Fax:352-787-0139
Practice Address - Street 1:981 DEL MAR DR
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-7734
Practice Address - Country:US
Practice Address - Phone:352-259-0893
Practice Address - Fax:352-787-0139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SDX HOME CARE OPERATIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-17
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992204253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care