Provider Demographics
NPI:1700571445
Name:HILLSBOROUGH HOME CARE LLC
Entity Type:Organization
Organization Name:HILLSBOROUGH HOME CARE LLC
Other - Org Name:SYNERGY HOMECARE OF TAMPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALAINA
Authorized Official - Middle Name:DYANN
Authorized Official - Last Name:TACKITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-367-6020
Mailing Address - Street 1:3500 E FLETCHER AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4712
Mailing Address - Country:US
Mailing Address - Phone:813-367-6020
Mailing Address - Fax:
Practice Address - Street 1:3500 E FLETCHER AVE STE 220
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4712
Practice Address - Country:US
Practice Address - Phone:813-367-6020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health