Provider Demographics
NPI:1588349336
Name:ATC SENIOR CARE, LLC
Entity type:Organization
Organization Name:ATC SENIOR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PIERRELA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERTILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-696-9542
Mailing Address - Street 1:740 SUNCREST LOOP APT 112
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-9043
Mailing Address - Country:US
Mailing Address - Phone:954-696-9542
Mailing Address - Fax:
Practice Address - Street 1:740 SUNCREST LOOP APT 112
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-9043
Practice Address - Country:US
Practice Address - Phone:954-696-9542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care