Althea Pontoon

Individual provider Active NPI In Home Supportive Care Agency · Hawthorne, FL

NPI 1306303169 · NPPES record last updated Feb 27, 2019

Key facts

NPI
1306303169
Entity type
Individual (NPI type 1)
Primary specialty
In Home Supportive Care Agency 253Z00000X
License
269536 (FL)
Practice address
144 Prairie Drive
Hawthorne, FL 32640
Phone
(352) 481-3331
Fax
(352) 481-5249
NPI assigned
Feb 27, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
269536FLMDIn Home Supportive Care Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 269536 FL Yes

Addresses

Primary practice location

144 Prairie Drive
Hawthorne, FL 32640

Mailing address

144 Prairie Drive
Hawthorne, FL 32640
Phone (352) 481-3331

Other providers in Hawthorne, FL

All providers in Hawthorne, FL · In Home Supportive Care Agency in Florida

Sources for this page

Verify at the official NPI Registry.