Healthcare Provider Details

I. General information

NPI: 1124449335
Provider Name (Legal Business Name): AT TALITHA CUMI HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5405 OKEECHOBEE BLVD STE 201
WEST PALM BEACH FL
33417-4544
US

IV. Provider business mailing address

1840 W 49TH ST STE 224
HIALEAH FL
33012-2949
US

V. Phone/Fax

Practice location:
  • Phone: 786-452-1226
  • Fax: 786-452-1227
Mailing address:
  • Phone: 786-452-1226
  • Fax: 786-452-1227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number232310
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: YASHIRA M. RIVAS
Title or Position: PRESIDENT
Credential:
Phone: 786-454-7021