Provider Demographics
NPI:1679721625
Name:INNOVATIVE SENIOR CARE HOME HEALTH OF OCALA LLC
Entity type:Organization
Organization Name:INNOVATIVE SENIOR CARE HOME HEALTH OF OCALA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO, HOME HEALTH & HOSPICE
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-565-8439
Mailing Address - Street 1:1 PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6527
Mailing Address - Country:US
Mailing Address - Phone:615-344-9551
Mailing Address - Fax:
Practice Address - Street 1:1950 LAUREL MANOR DR STE 120
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5602
Practice Address - Country:US
Practice Address - Phone:652-674-3280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH AT HOME-BHS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-03
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993616251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
109581Medicare Oscar/Certification