Provider Demographics
NPI:1891172771
Name:GREYSTONE HOME HEALTHCARE OF GREATER ORLANDO LLC
Entity Type:Organization
Organization Name:GREYSTONE HOME HEALTHCARE OF GREATER ORLANDO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:F
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-635-9500
Mailing Address - Street 1:12701 S JOHN YOUNG PKWY STE 219
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-3423
Mailing Address - Country:US
Mailing Address - Phone:407-855-5728
Mailing Address - Fax:407-855-5730
Practice Address - Street 1:12701 S JOHN YOUNG PKWY
Practice Address - Street 2:#219, #220
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-3420
Practice Address - Country:US
Practice Address - Phone:407-855-5728
Practice Address - Fax:407-855-5730
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREYSTONE HOME HEALTH OF FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-30
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992080251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health