Healthcare Provider Details

I. General information

NPI: 1275498826
Provider Name (Legal Business Name): CARE HARBOR HOME SUPPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 SE 1ST ST APT 606
POMPANO BEACH FL
33060-7575
US

IV. Provider business mailing address

475 SE 1ST ST APT 606
POMPANO BEACH FL
33060-7575
US

V. Phone/Fax

Practice location:
  • Phone: 954-756-0126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: TRACEY SANON
Title or Position: OWNER
Credential:
Phone: 954-756-0126