Organization
ATLANTIC CARE SERVICES HAINES CITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON COONS (OWNER)
(407) 484-2972
Entity
Organization
Contact information
Practice address
651 E MAIN ST STE 12, HAINES CITY, FL 33844-4241
(407) 270-5501
(407) 559-8971
Mailing address
1845 OAK LN, ORLANDO, FL 32803-1533
(407) 484-2972
(407) 559-8971
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108212400
—
FL
Enumeration date
09/29/2020
Last updated
11/05/2020
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