# GRANNY NANNIES OF NORTH AMERICA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Granny NANNIES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770257669
- **Authorized official:** MR. ROBERT DOUGLAS HODGSON (MEMBER)
- **Authorized official phone:** (407) 682-7758

## Contact information

- **Practice address:** 510 CO RD 466 SUITE 207 \#F, LADY LAKE, FL 32159
- **Practice address phone:** (352) 365-7866
- **Mailing address:** 1912 BOOTHE CIR STE 300, LONGWOOD, FL 32750-6709
- **Mailing address phone:** (407) 682-7758
- **Mailing address fax:** (407) 682-4569

## Taxonomy

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

## Other

- **Enumeration date:** 08/04/2021
- **Last updated:** 08/04/2021