Healthcare Provider Details

I. General information

NPI: 1801617386
Provider Name (Legal Business Name): SENIOR LOVING HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 NE 199TH ST APT 204
MIAMI FL
33179-3058
US

IV. Provider business mailing address

827 NE 199TH ST APT 204
MIAMI FL
33179-3058
US

V. Phone/Fax

Practice location:
  • Phone: 786-356-9468
  • Fax:
Mailing address:
  • Phone: 786-356-9468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KARLINE JEAN
Title or Position: ADMINISTRATOR
Credential: NURSING ASSISTANCE
Phone: 786-356-9468