Provider Demographics
NPI:1730953100
Name:SENIOR SUPPORT SERVICING HOME HEALTHCARE REGION 3, LLC
Entity type:Organization
Organization Name:SENIOR SUPPORT SERVICING HOME HEALTHCARE REGION 3, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:V
Authorized Official - Last Name:RAMKISSOON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:095-495-2010
Mailing Address - Street 1:510 CR 466 #207 S
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159
Mailing Address - Country:US
Mailing Address - Phone:800-610-7042
Mailing Address - Fax:813-692-1748
Practice Address - Street 1:510 CR 466 #207 S
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:800-610-7042
Practice Address - Fax:813-692-1748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health