Provider Demographics
NPI:1851552855
Name:SAMUELSON PERSONAL CARE LLC
Entity Type:Organization
Organization Name:SAMUELSON PERSONAL CARE LLC
Other - Org Name:DBA HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-622-6447
Mailing Address - Street 1:1411 NE 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-7733
Mailing Address - Country:US
Mailing Address - Phone:352-622-6447
Mailing Address - Fax:352-622-5578
Practice Address - Street 1:1411 NE 22ND AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-7733
Practice Address - Country:US
Practice Address - Phone:352-622-6447
Practice Address - Fax:352-622-5578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993167251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health