Organization
SKY LIMITS 1, INC
Active
Other names
HEAVENLY HOME PCS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTWON MONTAE TRICE (PRESIDENT)
(843) 655-5860
Entity
Organization
Contact information
Practice address
950 N COCOA BLVD, UNIT 102, COCOA, FL 32922-7582
(321) 632-0675
(321) 632-0673
Mailing address
PO BOX 372029, SATELLITE BEACH, FL 32937-0029
(321) 632-0675
(321) 632-0673
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
30211419
FL
251J00000X
Nursing Care Agency
30211419
FL
253Z00000X
In Home Supportive Care Agency
Primary
30211419
FL
Other
Enumeration date
09/24/2009
Last updated
09/24/2009
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