Provider Demographics
NPI:1720872625
Name:SWAN LOVING CARE HOME CARE AGENCY
Entity type:Organization
Organization Name:SWAN LOVING CARE HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMBALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-332-5482
Mailing Address - Street 1:795 COUNTY ROAD 1 LOT 212
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-6315
Mailing Address - Country:US
Mailing Address - Phone:727-332-5482
Mailing Address - Fax:
Practice Address - Street 1:795 COUNTY ROAD 1 LOT 212
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-6315
Practice Address - Country:US
Practice Address - Phone:727-332-5482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care