Healthcare Provider Details
I. General information
NPI: 1851346050
Provider Name (Legal Business Name): DUPLICATE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/24/2006
Last Update Date: 02/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 QUANTUM LAKES DR SUITE 108
BOYNTON BEACH FL
33426-8324
US
IV. Provider business mailing address
2500 QUANTUM LAKES DR SUITE 108
BOYNTON BEACH FL
33426-8324
US
V. Phone/Fax
- Phone: 561-244-0220
- Fax: 561-244-0222
- Phone: 561-244-0220
- Fax: 561-244-0222
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
MAXINE
HOCHHAUSER
Title or Position: CEO
Credential:
Phone: 561-244-3601