Organization
UNIQUE ADVANCED CARE SUPPORT SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMONIQUE N FASHAW (OWNER)
(352) 818-2814
Entity
Organization
Contact information
Practice address
1408 LONGVILLE CIR, TAVARES, FL 32778-4918
(352) 818-2814
Mailing address
1408 LONGVILLE CIR, TAVARES, FL 32778-4918
(352) 818-2814
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/19/2016
Last updated
08/19/2016
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