Provider Demographics
NPI:1134741176
Name:RELIABLE CARE: HOMEMAKER AND COMPANION SERVICES LLC
Entity type:Organization
Organization Name:RELIABLE CARE: HOMEMAKER AND COMPANION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:E
Authorized Official - Last Name:PENNY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:813-748-5907
Mailing Address - Street 1:8320 WILLOW BEACH DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4113
Mailing Address - Country:US
Mailing Address - Phone:813-748-5907
Mailing Address - Fax:
Practice Address - Street 1:8320 WILLOW BEACH DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4113
Practice Address - Country:US
Practice Address - Phone:813-748-5907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty