Provider Demographics
NPI:1871203646
Name:A GOOD STEWARD COMPANION SERVICE, LLC
Entity type:Organization
Organization Name:A GOOD STEWARD COMPANION SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-465-5551
Mailing Address - Street 1:2349 60TH AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-4542
Mailing Address - Country:US
Mailing Address - Phone:941-465-5551
Mailing Address - Fax:
Practice Address - Street 1:2349 60TH AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-4542
Practice Address - Country:US
Practice Address - Phone:941-465-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities