=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568708501
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YOURWAY HOME CARE SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2012
-----------------------------------------------------
Last Update Date | 12/20/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3238 W HILLSBORO BLVD
-----------------------------------------------------
City | DEERFIELD BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33442-9401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-420-9769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3238 W HILLSBORO BLVD
-----------------------------------------------------
City | DEERFIELD BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33442-9401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-420-9769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | MS. FABYOUNA LOUIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-420-9769
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number | 232968
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------