Healthcare Provider Details

I. General information

NPI: 1386933935
Provider Name (Legal Business Name): PSI HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3493 HIGH RIDGE RD
BOYNTON BEACH FL
33426-8739
US

IV. Provider business mailing address

3493 HIGH RIDGE ROAD
BOYNTON BEACH FL
33426
US

V. Phone/Fax

Practice location:
  • Phone: 561-740-4640
  • Fax: 561-740-4647
Mailing address:
  • Phone: 561-740-4640
  • Fax: 561-740-4647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS SYLVIA COOPER
Title or Position: MANAGER
Credential:
Phone: 561-740-4640