Provider Demographics
NPI:1588452924
Name:W SQUARED PCAH OF SARASOTA LLC
Entity type:Organization
Organization Name:W SQUARED PCAH OF SARASOTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-259-1155
Mailing Address - Street 1:3801 BEE RIDGE RD STE 7C
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1157
Mailing Address - Country:US
Mailing Address - Phone:941-259-1155
Mailing Address - Fax:
Practice Address - Street 1:3801 BEE RIDGE RD STE 7C
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1157
Practice Address - Country:US
Practice Address - Phone:941-259-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health