Organization
SUPPORTIVE COMPANIONS HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRSTON HARLEY (OWNER)
(352) 768-9549
Entity
Organization
Contact information
Practice address
2828 PALATINO LN, TAVARES, FL 32778-5626
(352) 768-9549
Mailing address
2828 PALATINO LN, TAVARES, FL 32778-5626
(352) 768-9549
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
—
122181600
—
FL
Enumeration date
07/09/2024
Last updated
07/09/2024
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