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Organization

MLS HOMEMAKER/COMPANION SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MAGNOLIA SOLOMON (OWNER)
(352) 603-0126
Entity
Organization

Contact information

Practice address
1406 COUNTY ROAD 228, WILDWOOD, FL 34785
(352) 571-0492
Mailing address
1406 COUNTY ROAD 228, WILDWOOD, FL 34785-8507
(352) 571-0492

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
233935
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015196100
FL
Enumeration date
11/09/2015
Last updated
11/09/2015
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