Organization
S.L. SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAMFA MONIFA LAPORTA (OWNER/OPERATOR)
(239) 297-0726
Entity
Organization
Contact information
Practice address
4401 TEASDALE DR, NORTH FORT MYERS, FL 33903-5837
(239) 297-0726
(888) 958-5726
Mailing address
4401 TEASDALE DR, NORTH FORT MYERS, FL 33903-5837
(239) 297-0726
(888) 958-5726
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
—
001310800
—
FL
Enumeration date
03/06/2015
Last updated
03/06/2015
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