Healthcare Provider Details

I. General information

NPI: 1609606680
Provider Name (Legal Business Name): EXQUISITE HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 EVANS AVE STE 4
FORT MYERS FL
33901-9365
US

IV. Provider business mailing address

727 BURNS AVE S
LEHIGH ACRES FL
33974-0593
US

V. Phone/Fax

Practice location:
  • Phone: 239-789-9193
  • Fax:
Mailing address:
  • Phone: 239-789-9193
  • Fax:

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: MRS. MARSHA DENISE REID
Title or Position: ADMINISTRATOR
Credential:
Phone: 239-789-9193