Provider Demographics
NPI:1760454342
Name:INTERIM HEALTHCARE OF NW FL INC
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF NW FL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:GAFF
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:850-422-2044
Mailing Address - Street 1:1962 VILLAGE GREEN WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-3800
Mailing Address - Country:US
Mailing Address - Phone:850-422-2044
Mailing Address - Fax:850-386-6985
Practice Address - Street 1:1962 VILLAGE GREEN WAY
Practice Address - Street 2:SUITE B
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-3800
Practice Address - Country:US
Practice Address - Phone:850-422-2044
Practice Address - Fax:850-386-6985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health