# MS PHYLLIS HOME CARE LLC

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

## Provider details

- **NPI number:** 1417525312
- **Authorized official:** MS. PHYLLIS ALFRED (OWNER/MANAGER)
- **Authorized official phone:** (352) 321-2727

## Contact information

- **Practice address:** 16903 LAKESIDE DR STE 4, MONTVERDE, FL 34756-3230
- **Practice address phone:** (321) 209-1322
- **Practice address fax:** (407) 386-7774
- **Mailing address:** 1121 STRATTON AVE, GROVELAND, FL 34736-8203
- **Mailing address phone:** (321) 209-1322
- **Mailing address fax:** (407) 386-7774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 06/16/2021
- **Last updated:** 07/24/2023