Provider Profile

WATERMAN VILLAGE HOME CARE

Home Health Agency

FACILITY PROFILE

Accredited by: Community Health Accreditation Program
Street Address
  • 130 WATERMAN AVE STE A
    MOUNT DORA, FL 32757-9519
    County: Lake
  • Phone: (352) 385-1138
Mailing Address
  • 130 WATERMAN AVE STE A
    MOUNT DORA, FL 32757-9519
    County: Lake
  • Phone: (352) 385-1138
AHCA Reports
Inspection Reports
Inspection Details
Consumer Guides
Home Health Care in Florida
Long-Term Care
Patient Safety
Health Care Advance Directives
Facility Information:
Facility/Provider Type:Home Health Agency
Administrator:JENNIFER BONGARD GIBSON
Chief Executive Officer:Not Available
Financial Officer:DAVID KARL LARSON
Owner/Licensee:WATERMAN COMMUNITIES, INC.
Owner/Licensee Since:8/14/2006

NamePositionOwnership
ANDREW MARK DUJONBOARD MEMBER/OFFICER0%
DAVID KARL LARSONBOARD MEMBER/OFFICER0%
DAVID NWOGUBOARD MEMBER/OFFICER0%
Profit Status:Not-For-Profit
Management Company:Not Available
Manager Since:Not Available
Licensed Beds:Not Available
AHCA Number (File Number):19965181
AHCA Field Office:03
License Number:213298
Current License Effective:2/27/2025
Current License Expires:2/26/2027
License Status:LICENSED
Services/Characteristics
Service Area:Lake
Accredited By:Community Health Accreditation Program
Accredited Deemed Status:State and Deemed for Federal
Certification Status:Medicare Certified
SERVICES PROVIDED:Home Health AideMedical Social ServicesNursing CareOccupational TherapyPhysical TherapySpeech Therapy
Special Designation:Skilled Services
Skilled Pediatric Services:No
Legal Actions
Please note the legal actions above may have been issued to a prior owner. The Final Order displays the name of the licensee responsible for the legal action that was taken.
Date Initiated Case # Case Type Violation Fine Amount Date Imposed
6/16/20102010006146FineReporting$5,000.007/26/2010
8/27/20082008010073FineApplication$250.0011/19/2008

Important information and facility/provider definitions can be found in the Glossary.

Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.