Healthcare Provider Details

I. General information

NPI: 1922051259
Provider Name (Legal Business Name): CARESERVICES OF THE PLATINUM COAST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 BAILEY LANE SUITE 105
NAPLES FL
34105-8522
US

IV. Provider business mailing address

2500 QUANTUM LAKES DR SUITE 108
BOYNTON BEACH FL
33426-8324
US

V. Phone/Fax

Practice location:
  • Phone: 239-436-3569
  • Fax: 239-436-3747
Mailing address:
  • Phone: 561-244-0220
  • Fax: 516-244-0221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA#202660952
License Number StateFL

VIII. Authorized Official

Name: MAXINE HOCHHAUSER
Title or Position: CEO
Credential:
Phone: 561-244-0220