GRANNY NANNIES LLC (NPI# 1760604664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760604664 |
| Entity Type | Organization |
| Organization Name | GRANNY NANNIES LLC |
| Practice Address |
1912 Boothe Cir Suite 300 Longwood FL 32750-6709 |
| Practice Telephone | 4076827758 |
| Practice Fax Number | 4076824569 |
| Mailing Telephone | 4076827758 |
| Mailing Fax Number | 4076824569 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-01-24 |
| Authorized Official Name | ROBERT DOUGLAS HODGSON (MEMBER) |
| Authorized Official Telephone | 4076827758 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | NR3010096 | FL | Agencies |
| N | 251E00000X | Home Health | NR30210990 | FL | Agencies |
| Y | 311Z00000X | Custodial Care Facility | NR3010096 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 675935100 | 05 | |
| FL | 6759351 | 05 | |
| FL | 675935104 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 510 Co Rd 466, Ste 207 #f, Lady Lake, FL 32159 | 3523657866 | 4076824569 |
| Street Address |
1912 BOOTHE CIR SUITE 300 |
| City | LONGWOOD |
| State | FL |
| Zip Code | 32750-6709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962794156 | Compass Behavioral Health LLC | Counselor | 1912 Boothe Cir, Suite 201, Longwood, FL 32750-6709 | 2011-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902420920 | Prn Speech Pathologists | Speech-Language Pathologist | 1704 N. Ronald Reagan Blvd, Longwood, FL 32750 | 2020-06-05 |
| 1831743368 | Shamar Anthony Marston | Nurse Anesthetist, Certified Registered | 555 W Fl - 434, Longwood, FL 32750 | 2019-08-01 |
| 1538639125 | Omega Healthcare Solutions, LLC | Case Management | 160 W. Evergreen Avenue Suite 290, Longwood, FL 32750 | 2018-11-27 |
| 1013416080 | Samantha Jane Roberts | Specialist/Technologist, Other | 163 W Bay Ave, Longwood, FL 32750 | 2018-02-06 |
| 1508375874 | Cassandra Thompson-bailey | Nurse Practitioner | 600 N Us Hwy 17 92, Suite 124, Longwood, FL 32750 | 2017-09-29 |
| 1740799535 | Cornerstone Longwood Leasing, LLC | Assisted Living Facility | 480 E. Church Ave., Longwood, FL 32750 | 2017-09-25 |
| 1659890523 | Melissa Shoshana Vigerito | Marriage & Family Therapist | 978 Douglas Ave. Suite 100, Altamonte Springs, FL 32750 | 2017-09-12 |
| 1619498185 | Calm Relief, LLC | Massage Therapist | 1855 W State Road 434, Ste 253, Longwood, FL 32750 | 2017-07-05 |
| 1497145148 | Caitlin Rhea Hilligas | Counselor | 300 N Ronald Reagan Blvd Ste 302, Longwood, FL 32750 | 2015-02-03 |
| 1316344054 | James David Rawlins Jr. | Dentist | 1250 W.s.r 434 Ste. 1008, Longwood, FL 32750 | 2014-11-24 |
| Find all providers in zip 32750 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184241804 | Assisted Living of Florida, Limited, Inc. | Custodial Care Facility | 10860 118th St, Seminole, FL 33778-3625 | 2020-06-29 |
| 1952936841 | Tequesta Dukes | Custodial Care Facility | 1713 W Marshall Lake Dr, Apopka, FL 32703-1622 | 2020-03-11 |
| 1881254712 | Claudette Paul | Custodial Care Facility | 4103 Day Bridge Pl, Ellenton, FL 34222-7236 | 2019-06-13 |
| 1366983140 | Medical Allied Nursing Academy, Inc. | Custodial Care Facility | 750 Plaza Orange Blossom Trail, Suite 264, Orlando, FL 32805 | 2017-03-14 |
| 1598204786 | Samantha Lamadieu | Custodial Care Facility | 709 S 51st St, Tampa, FL 33619-3703 | 2017-02-21 |
| 1578013033 | Aj Care Inc | Custodial Care Facility | 11990 Mellow Ct, West Palm Beach, FL 33411-9127 | 2016-10-09 |
| 1508225053 | Mccall Service, Inc. | Custodial Care Facility | 415 Nw 250th St, Suite 1, Newberry, FL 32669-4473 | 2016-02-12 |
| 1043679590 | Mccall Service, Inc. | Custodial Care Facility | 10211 E Columbus Dr, Tampa, FL 33619-7853 | 2016-02-12 |
| 1780043232 | Mccall Service, Inc. | Custodial Care Facility | 410 E Paul Russell Rd, Tallahassee, FL 32301-6960 | 2016-02-12 |
| 1588022909 | Brendlyn Assisted Living LLC | Custodial Care Facility | 81 Buttonworth Dr, Palm Coast, FL 32137-3507 | 2016-01-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.