Provider Demographics
NPI:1902083264
Name:FAGAN ASSOCIATES, INC
Entity Type:Organization
Organization Name:FAGAN ASSOCIATES, INC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-255-0645
Mailing Address - Street 1:933 BEVILLE RD
Mailing Address - Street 2:SUITE 101-G
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-1755
Mailing Address - Country:US
Mailing Address - Phone:386-255-0645
Mailing Address - Fax:386-255-6222
Practice Address - Street 1:933 BEVILLE RD
Practice Address - Street 2:SUITE 101-G
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-1755
Practice Address - Country:US
Practice Address - Phone:386-255-0645
Practice Address - Fax:386-255-6222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL227270251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health