Provider Demographics
NPI:1780282574
Name:UNIQUE CARE
Entity type:Organization
Organization Name:UNIQUE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KESHA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:DEPEIZA
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:352-440-4357
Mailing Address - Street 1:925 NE 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:FL
Mailing Address - Zip Code:32693-3627
Mailing Address - Country:US
Mailing Address - Phone:352-440-4357
Mailing Address - Fax:
Practice Address - Street 1:925 NE 11TH AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:FL
Practice Address - Zip Code:32693-3627
Practice Address - Country:US
Practice Address - Phone:352-440-4357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health