Provider Demographics
NPI:1386151108
Name:ATNB HOME CARE & LIFESTYLE MGT., LLC
Entity type:Organization
Organization Name:ATNB HOME CARE & LIFESTYLE MGT., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NINOSKA
Authorized Official - Middle Name:P
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-500-1976
Mailing Address - Street 1:2841 WINDSOR HEIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-2487
Mailing Address - Country:US
Mailing Address - Phone:386-500-1976
Mailing Address - Fax:
Practice Address - Street 1:801 INTERNATIONAL PKWY
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4762
Practice Address - Country:US
Practice Address - Phone:386-500-1976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization