Healthcare Provider Details

I. General information

NPI: 1427933233
Provider Name (Legal Business Name): NICMOY HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E PALMETTO PARK RD
BOCA RATON FL
33432-4827
US

IV. Provider business mailing address

150 E PALMETTO PARK RD STE 800
BOCA RATON FL
33432-4833
US

V. Phone/Fax

Practice location:
  • Phone: 561-465-7640
  • Fax: 954-206-5418
Mailing address:
  • Phone: 561-465-7640
  • Fax: 954-206-5418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: ILEENE N PARKER-SMITH
Title or Position: OWNER / ADMINISTRATOR
Credential:
Phone: 561-465-7640