Provider Demographics
NPI:1053733964
Name:MALONDA MITCHELL PERSONAL HOME CARE
Entity type:Organization
Organization Name:MALONDA MITCHELL PERSONAL HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-857-1613
Mailing Address - Street 1:8074 JUNIPER RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-8601
Mailing Address - Country:US
Mailing Address - Phone:352-857-1613
Mailing Address - Fax:
Practice Address - Street 1:8074 JUNIPER RD UNIT A
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-8601
Practice Address - Country:US
Practice Address - Phone:352-857-1613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MALONDA MITCHELL PERSONAL HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-11
Last Update Date:2014-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home