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Organization
PROMINENCES KINDRED CARE, LLC
Active
Organization
PROMINENCES KINDRED CARE, LLC
Active
Other names
Prominences Kindred Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDDIE LEE FAGAN JR. (MR.)
(717) 678-6321
Entity
Organization
Contact information
Practice address
1508 W ARCH ST STE A, TAMPA, FL 33607-5516
(717) 678-6321
(850) 260-0842
Mailing address
1508 W ARCH ST STE A, TAMPA, FL 33607-5516
(717) 678-6321
(850) 260-0842
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
01/08/2025
Last updated
01/08/2025
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