Provider Demographics
NPI:1194874776
Name:HESTIA HEALTHCARE AT HOME, LLC
Entity type:Organization
Organization Name:HESTIA HEALTHCARE AT HOME, 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 1:109 44TH AVE E STE 215
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-3639
Practice Address - Country:US
Practice Address - Phone:941-748-6010
Practice Address - Fax:941-747-5353
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH AT HOME-BHS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-10
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21127096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107656Medicare Oscar/Certification