# AZALEA HOME CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215535265
- **Authorized official:** JONOVAN STAFFORD (OWNER)
- **Authorized official phone:** (813) 862-1914

## Contact information

- **Practice address:** 400 N ASHLEY DR STE 2653, TAMPA, FL 33602-4300
- **Practice address phone:** (813) 862-1914
- **Mailing address:** 7624 TANGLE RUSH DR, GIBSONTON, FL 33534-5311
- **Mailing address phone:** (813) 862-1914

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/13/2020
- **Last updated:** 10/13/2020