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Organization
FOUR NINETEEN, LLC
Active
Organization
FOUR NINETEEN, LLC
Active
Other names
Homewatch CareGivers of Lakewood Ranch
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY BERNARD HAITZ III (OWNER)
(941) 920-0826
Entity
Organization
Contact information
Practice address
9015 TOWN CENTER PKWY, #104, LAKEWOOD RANCH, FL 34202-5012
(941) 920-0826
Mailing address
9015 TOWN CENTER PKWY, #104, LAKEWOOD RANCH, FL 34202-5012
(941) 920-0826
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
299994641
FL
253Z00000X
In Home Supportive Care Agency
—
NULL
Other
Enumeration date
09/29/2016
Last updated
09/28/2017
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