=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326264433
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTURY HOME CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2007
-----------------------------------------------------
Last Update Date | 06/30/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 71ST ST STE 440
-----------------------------------------------------
City | MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33141-3092
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-868-4725
-----------------------------------------------------
Fax | 305-868-4726
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 71ST ST STE 440
-----------------------------------------------------
City | MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33141-3092
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-302-2423
-----------------------------------------------------
Fax | 305-868-4726
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF NURSING
-----------------------------------------------------
Name | MRS. MERCEDES GARCIA
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 305-868-4725
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------