MEDICARE: ONEWAY FOUNDATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1205354016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONEWAY FOUNDATION LLC

Provider Business Mailing Address
First Line	:	5061 MARCIA PL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-1662
Country	:	US
Telephone Number	:	561-703-0193
Fax Number	:	561-531-5937

Provider Business Practice Location Address
First Line	:	5061 MARCIA PLACE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407
Country	:	US
Telephone Number	:	561-703-0193
Fax Number	:	561-531-5937

Authorized Official
Title or Position	:	ADMINISTRATOR/CFO
Name	:	DEANDRE RICHARDSON
Credential	:
Telephone Number	:	561-703-0193

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	07/21/2022

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