Provider Demographics
NPI:1124471057
Name:CAREGIVER AND COMPANION
Entity type:Organization
Organization Name:CAREGIVER AND COMPANION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-651-4037
Mailing Address - Street 1:533 E CITRUS ST
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-2614
Mailing Address - Country:US
Mailing Address - Phone:407-777-6035
Mailing Address - Fax:
Practice Address - Street 1:533 E CITRUS ST
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-2614
Practice Address - Country:US
Practice Address - Phone:407-777-6035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234216251E00000X
311ZA0620X, 163WH0200X, 376J00000X, 372500000X, 372600000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018204100Medicaid