Provider Demographics
NPI:1427352558
Name:DISCOVERY AT HOME LLC
Entity type:Organization
Organization Name:DISCOVERY AT HOME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CUNDIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-676-2080
Mailing Address - Street 1:4857 PALM BEACH BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-3206
Mailing Address - Country:US
Mailing Address - Phone:239-676-2080
Mailing Address - Fax:239-676-2089
Practice Address - Street 1:4857 PALM BEACH BLVD STE 4
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-3206
Practice Address - Country:US
Practice Address - Phone:239-676-2080
Practice Address - Fax:239-676-2089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health