Provider Demographics
NPI:1386473577
Name:KELLI CARE HOMEMAKER AND COMPANION SERVICES
Entity type:Organization
Organization Name:KELLI CARE HOMEMAKER AND COMPANION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:NIRA
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-952-8701
Mailing Address - Street 1:10303 RIVERBURN DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3164
Mailing Address - Country:US
Mailing Address - Phone:813-455-4683
Mailing Address - Fax:813-200-2446
Practice Address - Street 1:10303 RIVERBURN DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3164
Practice Address - Country:US
Practice Address - Phone:813-455-4683
Practice Address - Fax:813-200-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care