Healthcare Provider Details

I. General information

NPI: 1184151391
Provider Name (Legal Business Name): CHERY HEALTH CARE MULTI SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1739 QUEEN PALM WAY
NORTH PORT FL
34288-8656
US

IV. Provider business mailing address

PO BOX 7043
NORTH PORT FL
34290-0043
US

V. Phone/Fax

Practice location:
  • Phone: 941-777-3631
  • Fax: 941-227-1739
Mailing address:
  • Phone: 941-777-3631
  • Fax: 941-227-1739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: BERNARD V CHERY
Title or Position: VP
Credential:
Phone: 941-447-1401