Provider Demographics
NPI:1487293239
Name:RELIANCE HOME CARE, LLC
Entity type:Organization
Organization Name:RELIANCE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIEF EXPERIENCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMID
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:813-549-7808
Mailing Address - Street 1:20701 BRUCE B DOWNS BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3676
Mailing Address - Country:US
Mailing Address - Phone:813-549-7808
Mailing Address - Fax:
Practice Address - Street 1:20701 BRUCE B DOWNS BLVD STE 201
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3676
Practice Address - Country:US
Practice Address - Phone:813-549-7808
Practice Address - Fax:813-549-7813
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RELIANCE HOME CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0Other0
FL0Medicaid