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Organization

FLORIDA SENIOR CARE SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JERRY LLOYD TACKETT M.ED., BA, BS, AAMS. (VP BUSINESS DEVELOPMENT)
(772) 559-8673
Entity
Organization

Contact information

Practice address
5910 CARRIAGE LAKE CT, VERO BEACH, FL 32968-9476
(772) 559-8673
(772) 564-8719
Mailing address
PO BOX 691114, VERO BEACH, FL 32969-1114
(772) 559-8673
(772) 564-8719

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
SW6243
FL
251E00000X
Home Health Agency
SW6243
FL
251S00000X
Community/Behavioral Health Agency
Primary
SW6243
FL

Other

Enumeration date
01/14/2008
Last updated
01/14/2008
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