Healthcare Provider Details

I. General information

NPI: 1144183005
Provider Name (Legal Business Name): SIAH HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8104 SW 23RD ST # 28D
NORTH LAUDERDALE FL
33068-5005
US

IV. Provider business mailing address

8104 SW 23RD ST # 28D
NORTH LAUDERDALE FL
33068-5005
US

V. Phone/Fax

Practice location:
  • Phone: 954-800-3685
  • Fax:
Mailing address:
  • Phone: 954-800-3685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SHANDEANA PRATT
Title or Position: OWNER
Credential:
Phone: 954-800-3685