Healthcare Provider Details

I. General information

NPI: 1376249631
Provider Name (Legal Business Name): A FRIEND OF MINE HOMENAKER AND COMPANION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4781 N CONGRESS AVE # 1293
BOYNTON BEACH FL
33426-7941
US

IV. Provider business mailing address

4781 N CONGRESS AVE # 1293
BOYNTON BEACH FL
33426-7941
US

V. Phone/Fax

Practice location:
  • Phone: 954-934-7439
  • Fax:
Mailing address:
  • Phone: 954-934-7439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL R FRANCIS
Title or Position: OWNER
Credential:
Phone: 954-934-7439