Healthcare Provider Details

I. General information

NPI: 1780928929
Provider Name (Legal Business Name): 1ST ACCREDITED HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2012
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2332 SW 67TH AVE
MIAMI FL
33155-1846
US

IV. Provider business mailing address

2332 SW 67TH AVE
MIAMI FL
33155-1846
US

V. Phone/Fax

Practice location:
  • Phone: 786-502-8188
  • Fax: 786-502-8027
Mailing address:
  • Phone: 786-502-8188
  • Fax: 786-502-8027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHOME HEALTH
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ISABEL CHRISTINA LLANES
Title or Position: ALTERNATE ADMINISTRATOR/OWNER
Credential:
Phone: 786-470-6223