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General NPI Number Information
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NPI Number | 1104911064
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Entity Type | Organization
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Legal Business Name | ATLANTIC HOME CARE SERVICES CORP.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 01/06/2010
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Provider Practice Location Address
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Address Line | 3785 NW 82ND AVE STE 317
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City | DORAL
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State | FL
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Zip | 33166-6631
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Country | US
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Telephone | 786-331-8143
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Fax | 786-331-8348
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Provider Business Mailing Address
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Address Line | 3785 NW 82ND AVE STE 317
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City | DORAL
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State | FL
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Zip | 33166-6631
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Country | US
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Telephone | 786-331-8143
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Fax | 786-331-8348
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSE TRIGOSO
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Credential |
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Telephone | 786-331-8143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299991739
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License Number State | FL
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