Provider Demographics
NPI:1811446263
Name:PICTURE PERFECT HOME HEALTH
Entity type:Organization
Organization Name:PICTURE PERFECT HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER/OPERATER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:LETESSIA
Authorized Official - Last Name:MCKINNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-363-0516
Mailing Address - Street 1:1304 E COLUMBIA RD LOT 14
Mailing Address - Street 2:
Mailing Address - City:NEWVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36353-4053
Mailing Address - Country:US
Mailing Address - Phone:352-363-0516
Mailing Address - Fax:
Practice Address - Street 1:1304 E COLUMBIA RD LOT 14
Practice Address - Street 2:
Practice Address - City:NEWVILLE
Practice Address - State:AL
Practice Address - Zip Code:36353-4053
Practice Address - Country:US
Practice Address - Phone:352-363-0516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health