Healthcare Provider Details

I. General information

NPI: 1477507887
Provider Name (Legal Business Name): CBAH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 NW 50TH ST STE 203B
SUNRISE FL
33351-8061
US

IV. Provider business mailing address

10001 NW 50TH ST STE 203B
SUNRISE FL
33351-8061
US

V. Phone/Fax

Practice location:
  • Phone: 954-914-0811
  • Fax: 954-374-6989
Mailing address:
  • Phone: 954-914-0811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number228665
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: ALTHEA ROBINSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 954-914-0811