Healthcare Provider Details

I. General information

NPI: 1134539331
Provider Name (Legal Business Name): GRAPEVINE CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 02/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 BELVEDERE RD UNIT 4
WEST PALM BEACH FL
33411-3201
US

IV. Provider business mailing address

8120 BELVEDERE RD UNIT 4
WEST PALM BEACH FL
33411-3201
US

V. Phone/Fax

Practice location:
  • Phone: 561-899-0664
  • Fax: 888-600-5510
Mailing address:
  • Phone: 561-899-0664
  • Fax: 888-600-5510

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 Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. ERIN JENE FOLEY
Title or Position: VICE PRESIDENT
Credential:
Phone: 561-436-7711