Provider Demographics
NPI:1811095268
Name:TOTAL SENIOR HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:TOTAL SENIOR HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-444-6014
Mailing Address - Street 1:12800 UNIVERSITY DR
Mailing Address - Street 2:SUITE 335
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5332
Mailing Address - Country:US
Mailing Address - Phone:239-390-2032
Mailing Address - Fax:239-495-0628
Practice Address - Street 1:12800 UNIVERSITY DR
Practice Address - Street 2:SUITE 335
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5332
Practice Address - Country:US
Practice Address - Phone:239-390-2032
Practice Address - Fax:239-495-0628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL108260251E00000X
FL299992229251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108260Medicare ID - Type UnspecifiedHOME HEALTH AGENCY