Organization
SUNCREST HOME HEALTH OF TAMPA, LLC
Active
Other names
SunCrest OMNI
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS GACHASSIN III (EXECUTIVE VICE PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
311 PARK PLACE BLVD STE 120, CLEARWATER, FL 33759-4904
(727) 260-6680
(727) 441-8311
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104652000
—
FL
Enumeration date
10/11/2019
Last updated
04/20/2021
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