Healthcare Provider Details

I. General information

NPI: 1932361631
Provider Name (Legal Business Name): CARESERVICES OF THE HEARTLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 05/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 CORPOREX PARK DR SUITE 300
TAMPA FL
33619-1189
US

IV. Provider business mailing address

2400 HIGH RIDGE RD SUITE 101 AND 103
BOYNTON BEACH FL
33426-8725
US

V. Phone/Fax

Practice location:
  • Phone: 813-630-4336
  • Fax: 813-864-1003
Mailing address:
  • Phone: 561-244-0220
  • Fax: 561-244-0221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number6509037-01
License Number StateFL

VIII. Authorized Official

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