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Organization
3D PROVIDERS CORPORATION
Active
Organization
3D PROVIDERS CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA DELBENE (PRESIDENT)
(386) 752-0024
Entity
Organization
Contact information
Practice address
144 SW WATERFORD CT, SUITE 101, LAKE CITY, FL 32025-0767
(386) 752-0024
Mailing address
111 SW SABRE AVE, LAKE CITY, FL 32024-0923
(386) 755-3465
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
NULL
251J00000X
Nursing Care Agency
1370
FL
372600000X
Adult Companion
—
NULL
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
NULL
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
FL
385H00000X
Respite Care
Primary
—
NULL
385HR2065X
Child Physical Disabilities Respite Care
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1370
HEALTH CARE SERVICES POOL
FL
01
—
232905
HOMEMAKER & COMPANION /AHCA
FL
01
—
679482301
ELDER OPTIONS
FL
01
—
679482396
MEDICAID-WAIVER
FL
01
—
679482398
FLORIDA SUPPORTED LIVING WAIVER
FL
Enumeration date
09/03/2008
Last updated
10/23/2014
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