Provider Demographics
NPI:1245987502
Name:OUR LIVES MATTER HOME CARE LLC
Entity type:Organization
Organization Name:OUR LIVES MATTER HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANESHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRUMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-482-9266
Mailing Address - Street 1:429 88TH AVE N APT 4
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-3151
Mailing Address - Country:US
Mailing Address - Phone:727-482-9266
Mailing Address - Fax:
Practice Address - Street 1:429 88TH AVE N APT 4
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-3151
Practice Address - Country:US
Practice Address - Phone:727-482-9266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No332U00000XSuppliersHome Delivered Meals
No342000000XTransportation ServicesTransportation Network Company
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)