Provider Demographics
NPI:1649982877
Name:FIRST SENIOR HOME HEALTH IV, LLC
Entity type:Organization
Organization Name:FIRST SENIOR HOME HEALTH IV, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMENDARES
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:813-245-1789
Mailing Address - Street 1:2573 BARRINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-6805
Mailing Address - Country:US
Mailing Address - Phone:850-583-7990
Mailing Address - Fax:
Practice Address - Street 1:417 STOWE AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5580
Practice Address - Country:US
Practice Address - Phone:813-245-1789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health