# GRANNYS IN HOME CARE, INC.

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

## Provider details

- **NPI number:** 1457950479
- **Authorized official:** NECOLE JAVAN DULING RN (NURSE)
- **Authorized official phone:** (863) 808-3533

## Contact information

- **Practice address:** 4415 FLORIDA NATIONAL DR STE 201, LAKELAND, FL 33813-1569
- **Practice address phone:** (863) 808-3533
- **Mailing address:** PO BOX 91092, LAKELAND, FL 33804-1092
- **Mailing address phone:** (863) 808-3533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WA2000X | Administrator Registered Nurse | — | NULL | — |
| 163WA2000X | Administrator Registered Nurse | — | — | — |
| 163WH0200X | Home Health Registered Nurse | — | NULL | Yes |
| 163WH0200X | Home Health Registered Nurse | — | — | Yes |
| 172A00000X | Driver | — | NULL | — |
| 172A00000X | Driver | — | — | — |
| 372600000X | Adult Companion | — | NULL | — |
| 372600000X | Adult Companion | — | — | — |
| 376J00000X | Homemaker | — | NULL | — |
| 376J00000X | Homemaker | — | — | — |

## Other

- **Enumeration date:** 10/21/2020
- **Last updated:** 10/21/2020