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General NPI Number Information
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NPI Number | 1023449808
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Entity Type | Organization
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Legal Business Name | TOP CLASS HOME CARE SERVICES
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Dates
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Enumeration Date | 12/04/2013
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 127 NW 4TH AVE
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4115
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Country | US
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Telephone | 305-907-1513
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Fax | 305-907-1513
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Provider Business Mailing Address
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Address Line | 127 NW 4TH AVE
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4115
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Country | US
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Telephone | 305-907-1513
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Fax | 305-907-1513
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | RICHARD PETGRAVE
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Credential |
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Telephone | 786-859-7265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 233327
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License Number State | FL
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