MEDICARE: A SIGNATURE LIVING PERSONALIZED CARE AT HOME, 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	:	1710821970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A SIGNATURE LIVING PERSONALIZED CARE AT HOME, LLC

Provider Business Mailing Address
First Line	:	2598 E SUNRISE BLVD STE 2104
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3230
Country	:	US
Telephone Number	:	770-843-7188
Fax Number	:

Provider Business Practice Location Address
First Line	:	2598 E SUNRISE BLVD STE 2104
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3230
Country	:	US
Telephone Number	:	770-843-7188
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	PAULAMAE DELORIS HARRIS
Credential	:	RN
Telephone Number	:	770-843-7188

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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