Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Supportive Space Home Care

Organization Homemaker · NPI 1184592404

Supportive Space Home Care is a Homemaker in Davenport, Florida. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

352 Tanglewood Dr
Davenport, FL 33896-3106
Phone: (317) 473-0037
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Homemaker (primary) Taxonomy 376J00000X

Record details

NPI number1184592404
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Monique Cannon — Admin · (317) 473-0037
NPI enumeratedOctober 28, 2025
Last updated in NPPESNovember 18, 2025
Certification dateNovember 18, 2025
Mailing address352 Tanglewood Dr, Davenport, FL 33896-3106

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