Provider Demographics
NPI:1154121697
Name:ENCORE IN HOME HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:ENCORE IN HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:J
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-386-0074
Mailing Address - Street 1:25 N MARKET ST STE 205
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-2802
Mailing Address - Country:US
Mailing Address - Phone:407-797-5735
Mailing Address - Fax:
Practice Address - Street 1:1400 E 105TH ST STE 2
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1101
Practice Address - Country:US
Practice Address - Phone:800-395-9420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-14
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care