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General NPI Number Information
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NPI Number | 1346883741
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Entity Type | Organization
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Legal Business Name | CREDIBLE HEALTH HOMECARE, LLC
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Dates
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Enumeration Date | 10/18/2019
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Last Update Date | 10/18/2019
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Provider Practice Location Address
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Address Line | 200 KNUTH RD, STE 238E
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4637
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Country | US
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Telephone | 561-279-3000
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Fax | 561-336-6400
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Provider Business Mailing Address
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Address Line | 200 KNUTH RD, STE 238E
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4637
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Country | US
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Telephone | 561-279-3000
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Fax | 561-336-6400
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEAMESLY ESTHEMA
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Credential |
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Telephone | 561-279-3000
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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 |
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License Number State |
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