Organization
AMERICAN HOME THERAPY PROVIDER, INC.
Active
Parent organization
AMERICAN HOME THERAPY PROVIDER,INC.
Other names
american home care
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN HOME THERAPY PROVIDER,INC.
Authorized official
MRS. GRACE PENANO RPT (ADMINISTRATOR/COO)
(941) 505-4663
Entity
Organization
Contact information
Practice address
2421 SHREVE ST STE 113, PUNTA GORDA, FL 33950-5972
(941) 505-4663
(941) 575-4445
Mailing address
2421 SHREVE ST STE 113, PUNTA GORDA, FL 33950-5972
(941) 505-4663
(941) 575-4445
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
299991531
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107737
MEDICARE 107737
FL
01
—
JW4
BCBS FL
FL
Enumeration date
11/01/2006
Last updated
03/31/2009
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