Organization
GRANNY NANNIES OF NORTH AMERICA LLC
Active
Other names
Granny NANNIES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DOUGLAS HODGSON (MEMBER)
(407) 682-7758
Entity
Organization
Contact information
Practice address
510 CO RD 466 SUITE 207 #F, LADY LAKE, FL 32159
(352) 365-7866
Mailing address
1912 BOOTHE CIR STE 300, LONGWOOD, FL 32750-6709
(407) 682-7758
(407) 682-4569
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
675935104
—
FL
Enumeration date
08/04/2021
Last updated
08/04/2021
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