Provider Demographics
NPI:1679798821
Name:HOMETOWN HOMECARE, LLC
Entity type:Organization
Organization Name:HOMETOWN HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GM/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:VANZANT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:863-937-8960
Mailing Address - Street 1:4500 140TH AVE N
Mailing Address - Street 2:SUITE E202
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-3803
Mailing Address - Country:US
Mailing Address - Phone:727-953-9802
Mailing Address - Fax:727-674-2980
Practice Address - Street 1:4500 140TH AVE N
Practice Address - Street 2:SUITE E202
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-3803
Practice Address - Country:US
Practice Address - Phone:727-953-9802
Practice Address - Fax:727-674-2980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-14
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health