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General NPI Number Information
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NPI Number | 1508465725
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Entity Type | Organization
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Legal Business Name | MAHANAIM HOME CARE L.L.C.
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 2750 N 29TH AVE STE 218B
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City | HOLLYWOOD
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State | FL
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Zip | 33020-1521
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Country | US
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Telephone | 954-270-0563
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Fax |
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Provider Business Mailing Address
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Address Line | 2750 N 29 AVENUE SUITE 218B
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City | HOLLYWOOD FL
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State | FL
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Zip | 33020-3982
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Country | US
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Telephone | 954-270-0563
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. MYRIAM FRAZIL
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Credential | R.N.
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Telephone | 954-270-0562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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