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General NPI Number Information
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NPI Number | 1043886260
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Entity Type | Organization
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Legal Business Name | RWW HOME AND COMMUNITY REHAB SERVICES FLORIDA, LLC
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Dates
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Enumeration Date | 05/28/2021
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 11410 N KENDALL DR STE 303
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City | MIAMI
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State | FL
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Zip | 33176-1031
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Country | US
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Telephone | 786-746-6375
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Fax |
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Provider Business Mailing Address
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Address Line | 805 N WHITTINGTON PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40222-7101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT MANAGER
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Name | ANGIE MATTINGLY
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Credential |
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Telephone | 502-381-3579
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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