Provider Demographics
NPI:1861858193
Name:DURANT HOME LLC
Entity Type:Organization
Organization Name:DURANT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-737-1736
Mailing Address - Street 1:6929 DURANT RD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33567-3266
Mailing Address - Country:US
Mailing Address - Phone:813-737-1736
Mailing Address - Fax:813-381-5330
Practice Address - Street 1:6929 DURANT RD
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33567-3266
Practice Address - Country:US
Practice Address - Phone:813-737-1736
Practice Address - Fax:813-381-5330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL6680310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility