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General NPI Number Information
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NPI Number | 1114124955
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Entity Type | Organization
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Legal Business Name | MALIBU LOVE & CARE HEALTHCARE AGENCY INC
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 07/11/2020
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Provider Practice Location Address
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Address Line | 1468 S PALM AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-5520
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Country | US
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Telephone | 954-362-3831
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Fax | 954-362-3832
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Provider Business Mailing Address
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Address Line | 1468 S PALM AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-5520
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Country | US
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Telephone | 954-362-3831
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. ROSEMARIE NICHOLAS
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Credential |
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Telephone | 954-362-3831
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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 | 299992636
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License Number State | FL
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