Provider Demographics
NPI:1841604139
Name:GENERATIONS AT HOME LLC
Entity type:Organization
Organization Name:GENERATIONS AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDARALE-MOFFATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-422-6543
Mailing Address - Street 1:210 S PINELLAS AVE
Mailing Address - Street 2:SUITE 158
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-3672
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 S PINELLAS AVE
Practice Address - Street 2:SUITE 158
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-3672
Practice Address - Country:US
Practice Address - Phone:727-940-3414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care