Organization
TOTAL COMPLETE CARE AND TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHADEANA S NICHOLSON CNA (OWNER)
(941) 549-4120
Entity
Organization
Contact information
Practice address
4227 LARKIN ST, SARASOTA, FL 34232-5024
(941) 549-4120
Mailing address
4058 N BISCAYNE DR, NORTH PORT, FL 34291-7062
(941) 549-4120
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107572700
—
FL
01
—
908363877
BUSINESS CAR INSURANCE
FL
01
—
N242797859110
DRIVERS LICENSE
FL
01
—
U4219
CERTIFICATE OF LIABILITY INSURANCE
FL
Enumeration date
03/03/2023
Last updated
03/06/2024
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