Basic Information
| Provider Information | |||||||||
| NPI: | 1689069528 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LIGHT & HOPE HOME CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3105 W WATERS AVE | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336142869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545366418 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3105 W WATERS AVE | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336142869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545366418 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2015 | ||||||||
| LastUpdateDate: | 03/30/2015 | ||||||||
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| AuthorizedOfficialLastName: | ARENCIBIA | ||||||||
| AuthorizedOfficialFirstName: | ALEXEIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9545366418 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | FL | Y | Agencies | Home Health |
No ID Information.