Organization
TIME OUT RESPITE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON CHRISTINA HARTZELL (ADMINISTRATOR)
(941) 743-3883
Entity
Organization
Contact information
Practice address
24246 HARBORVIEW RD, PORT CHARLOTTE, FL 33980-2232
(941) 743-3883
(941) 743-4369
Mailing address
24246 HARBORVIEW RD, PORT CHARLOTTE, FL 33980-2232
(941) 743-3883
(941) 743-4369
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
089079
FL
253Z00000X
In Home Supportive Care Agency
089079
FL
343900000X
Non-emergency Medical Transport (VAN)
Primary
089079
FL
385HR2065X
Child Physical Disabilities Respite Care
089079
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251C00000X
—
FL
05
—
253200000X
—
FL
05
—
347800000X
—
FL
05
—
385H00000X
—
FL
Enumeration date
12/15/2010
Last updated
12/15/2010
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