Organization
BLACKWELL COMPANION CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RADAREON BLACKWELL LPN (ADMINISTRATOR)
(352) 603-6935
Entity
Organization
Contact information
Practice address
797 TEAGUE TRL APT 10107, LADY LAKE, FL 32159-3149
(352) 818-0405
Mailing address
797 TEAGUE TRL APT 10107, LADY LAKE, FL 32159-3149
(352) 818-0405
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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