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General NPI Number Information
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NPI Number | 1356014674
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Entity Type | Organization
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Legal Business Name | GENERATIONS PLUS LLC
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Dates
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Enumeration Date | 08/01/2021
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Last Update Date | 09/06/2021
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Provider Practice Location Address
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Address Line | 3901 NW 79TH AVE STE 245
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City | DORAL
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State | FL
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Zip | 33166-6506
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Country | US
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Telephone | 772-494-1321
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 882212
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City | PORT ST LUCIE
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State | FL
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Zip | 34988-2212
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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 | ADMINISTRATOR
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Name | LENTZ DORCELY
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Credential | DRPH,MPH
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Telephone | 954-740-3814
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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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