Provider Demographics
NPI:1962247551
Name:HOME CARE COLLECTIVE LLC
Entity type:Organization
Organization Name:HOME CARE COLLECTIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:239-205-9460
Mailing Address - Street 1:9180 GALLERIA CT STE 700
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-4385
Mailing Address - Country:US
Mailing Address - Phone:239-205-9460
Mailing Address - Fax:239-205-9462
Practice Address - Street 1:9180 GALLERIA CT STE 700
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-4385
Practice Address - Country:US
Practice Address - Phone:239-205-9460
Practice Address - Fax:239-205-9462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health