Provider Demographics
NPI:1972701183
Name:HOME HEALTH CONNECTION
Entity Type:Organization
Organization Name:HOME HEALTH CONNECTION
Other - Org Name:HOME HEALTH CONNECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVERINGHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-378-1474
Mailing Address - Street 1:24160 STATE ROAD 54 STE 5
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-6766
Mailing Address - Country:US
Mailing Address - Phone:813-994-7826
Mailing Address - Fax:813-994-8035
Practice Address - Street 1:24160 STATE ROAD 54 STE 5
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-6766
Practice Address - Country:US
Practice Address - Phone:813-994-7826
Practice Address - Fax:813-994-8035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992805251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651648300Medicaid
FL10-9141Medicare PIN