Provider Demographics
NPI:1568260420
Name:SHIRLEY'S COMASSIONATE CARE LLC
Entity type:Organization
Organization Name:SHIRLEY'S COMASSIONATE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JALISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-947-1704
Mailing Address - Street 1:413 JUNE AVE
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-7211
Mailing Address - Country:US
Mailing Address - Phone:407-947-1704
Mailing Address - Fax:407-947-1704
Practice Address - Street 1:65 3RD ST NW STE 203
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4638
Practice Address - Country:US
Practice Address - Phone:407-947-1704
Practice Address - Fax:407-947-1704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child