Provider Demographics
NPI:1689430423
Name:ELDER CARE SERVICES OF FL, LLC
Entity Type:Organization
Organization Name:ELDER CARE SERVICES OF FL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOWANNER
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-716-1778
Mailing Address - Street 1:11232 BLACK FOREST TRL
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5512
Mailing Address - Country:US
Mailing Address - Phone:813-716-1778
Mailing Address - Fax:
Practice Address - Street 1:11232 BLACK FOREST TRL
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5512
Practice Address - Country:US
Practice Address - Phone:813-716-1778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care