Provider Demographics
NPI:1700188679
Name:MYHYLANDERS ELDERCARE, LLC
Entity Type:Organization
Organization Name:MYHYLANDERS ELDERCARE, LLC
Other - Org Name:GRANNY NANNIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HYLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-203-1670
Mailing Address - Street 1:5668 GULF BREEZE PKWY
Mailing Address - Street 2:SUITE B-12
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-9524
Mailing Address - Country:US
Mailing Address - Phone:850-203-1670
Mailing Address - Fax:850-203-1674
Practice Address - Street 1:5668 GULF BREEZE PKWY
Practice Address - Street 2:SUITE B-12
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-9524
Practice Address - Country:US
Practice Address - Phone:850-203-1670
Practice Address - Fax:850-203-1674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNR30211252253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care