Provider Demographics
NPI:1083402945
Name:ST MARK VILLAGE HOME HEALTH INC
Entity type:Organization
Organization Name:ST MARK VILLAGE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DECURNOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-464-1706
Mailing Address - Street 1:2655 NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2630
Mailing Address - Country:US
Mailing Address - Phone:727-464-1706
Mailing Address - Fax:
Practice Address - Street 1:2655 NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2630
Practice Address - Country:US
Practice Address - Phone:727-464-1706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health