Organization
ATLANTIC IN-HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY EVANS (CFO)
(772) 462-6707
Entity
Organization
Contact information
Practice address
240 NW PEACOCK BLVD STE 304, PORT SAINT LUCIE, FL 34986-2274
(772) 462-6707
(772) 462-6706
Mailing address
240 NW PEACOCK BLVD STE 304, PORT ST LUCIE, FL 34986-2274
(772) 462-6707
(772) 463-6706
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
NR30211036
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016181800
—
FL
Enumeration date
09/10/2015
Last updated
07/19/2022
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