Healthcare Provider Details
I. General information
NPI: 1326367681
Provider Name (Legal Business Name): PATIENT CARE HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1489 W PALMETTO PARK RD SUITE NO 390
BOCA RATON FL
33486-3325
US
IV. Provider business mailing address
1489 W PALMETTO PARK RD SUITE NO 390
BOCA RATON FL
33486-3325
US
V. Phone/Fax
- Phone: 561-372-7185
- Fax: 561-372-7188
- Phone: 561-372-7185
- Fax: 561-372-7188
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 299993700 |
| License Number State | FL |
VIII. Authorized Official
Name:
CARLOS
F
VALENCIA
Title or Position: MANAGER
Credential:
Phone: 786-299-0202