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General NPI Number Information
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NPI Number | 1427651017
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Entity Type | Organization
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Legal Business Name | MYRTLE'S HOME HEALTH AGENCY LLC
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 6101 W ATLANTIC BLVD STE 204
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City | MARGATE
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State | FL
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Zip | 33063-5157
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Country | US
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Telephone | 754-422-2834
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Fax |
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Provider Business Mailing Address
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Address Line | 6101 W ATLANTIC BLVD STE 204
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City | MARGATE
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State | FL
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Zip | 33063-5157
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Country | US
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Telephone | 754-422-2834
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MARLENE EDGHILL
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Credential | LPN
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Telephone | 754-422-2834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #3
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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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