Provider Demographics
NPI:1942608237
Name:CSHHA NORTH FLORIDA, LLC
Entity Type:Organization
Organization Name:CSHHA NORTH FLORIDA, LLC
Other - Org Name:CORNERSTONE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAGLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:386-362-8552
Mailing Address - Street 1:1370 SARNO ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935
Mailing Address - Country:US
Mailing Address - Phone:321-428-4866
Mailing Address - Fax:321-428-4867
Practice Address - Street 1:1370 SARNO ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935
Practice Address - Country:US
Practice Address - Phone:321-428-4866
Practice Address - Fax:321-428-4867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299994435OtherAHCA LICENSE #