Healthcare Provider Details

I. General information

NPI: 1912425513
Provider Name (Legal Business Name): PASSIONATE CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2017
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 CORPORATE WAY STE 111
WEST PALM BEACH FL
33407-2041
US

IV. Provider business mailing address

5601 CORPORATE WAY STE 111
WEST PALM BEACH FL
33407-2041
US

V. Phone/Fax

Practice location:
  • Phone: 561-421-2494
  • Fax: 561-429-4504
Mailing address:
  • Phone: 561-421-2494
  • Fax:

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 Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE DANIELLE SCOTT
Title or Position: OWNER
Credential:
Phone: 561-421-2494