Provider Demographics
NPI:1447347497
Name:A PALMS PERSONAL CARE & HMKG SERVICES, LLC.
Entity type:Organization
Organization Name:A PALMS PERSONAL CARE & HMKG SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:READEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-682-0054
Mailing Address - Street 1:3515 PALM HARBOR BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1413
Mailing Address - Country:US
Mailing Address - Phone:727-682-0054
Mailing Address - Fax:727-935-4844
Practice Address - Street 1:3515 PALM HARBOR BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-1413
Practice Address - Country:US
Practice Address - Phone:727-682-0054
Practice Address - Fax:727-785-2484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211279251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03-3347382OtherTAX ACCOUNT NUMBER