MEDICARE: DIVERSE HOME CARE SERVICES INC

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
2	3747A0650X	Attendant Care Provider

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922560929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVERSE HOME CARE SERVICES INC

Provider Business Mailing Address
First Line	:	11820 MIRAMAR PKWY STE 219
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-5818
Country	:	US
Telephone Number	:	954-743-6233
Fax Number	:	954-416-9070

Provider Business Practice Location Address
First Line	:	11820 MIRAMAR PKWY STE 219
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-5818
Country	:	US
Telephone Number	:	954-743-6233
Fax Number	:	954-416-9070

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LEYSI M CASANOVA
Credential	:
Telephone Number	:	786-773-5112

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	12/04/2023

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Directions to “DIVERSE HOME CARE SERVICES INC ” Practice Location

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