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Organization

FOOTPRINTS HOME CARE SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YVONNE LEKELEFAC (MEMBER)
(260) 579-6648
Entity
Organization

Contact information

Practice address
2310 WHITEWOOD AVE, SPRING HILL, FL 34609-5061
(813) 345-7067
Mailing address
35324 SR 54, ZEPHYRHILLS, FL 33541-1942
(813) 395-5269

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
253Z00000X
In Home Supportive Care Agency
261QD1600X
Developmental Disabilities Clinic/Center
310400000X
Assisted Living Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11920
AHCA
FL
05
679403
FL
01
PENDING
AHCA
FL
Enumeration date
09/18/2017
Last updated
11/01/2023
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