Provider Demographics
NPI:1982218764
Name:THE HOME W/ GUIDING HANDS
Entity Type:Organization
Organization Name:THE HOME W/ GUIDING HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANCONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-709-1371
Mailing Address - Street 1:1256 N FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-2004
Mailing Address - Country:US
Mailing Address - Phone:727-709-1371
Mailing Address - Fax:
Practice Address - Street 1:1256 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-2004
Practice Address - Country:US
Practice Address - Phone:727-709-1371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities