Organization
FOUR NINETEEN, LLC
Active
Other names
Homewatch CareGivers of Lakewood Ranch
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY BERNARD HAITZ III (OWNER)
(941) 920-0826
Entity
Organization
Contact information
Practice address
9015 TOWN CENTER PKWY, #104, LAKEWOOD RANCH, FL 34202-5012
(941) 920-0826
Mailing address
9015 TOWN CENTER PKWY, #104, LAKEWOOD RANCH, FL 34202-5012
(941) 920-0826
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
299994641
FL
253Z00000X
In Home Supportive Care Agency
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Other
Enumeration date
09/29/2016
Last updated
09/28/2017
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