Organization
HOME HEALTH AGENCY - BREVARD, LLC
Active
Other names
SunCrest OMNI
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MCFADDIN (DIRECTOR OF LICENSING/ACCREDITATION)
(615) 712-2250
Entity
Organization
Contact information
Practice address
780 S APOLLO BLVD, SUITE 106, MELBOURNE, FL 32901-1402
(321) 752-9292
(321) 752-9284
Mailing address
510 HOSPITAL DR, SUITE 150, MADISON, TN 37115-5033
(615) 627-9267
(615) 577-0081
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
299991913
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004233700
—
FL
Enumeration date
09/08/2005
Last updated
06/29/2012
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