=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609613017
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALPERISE HOMECARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2024
-----------------------------------------------------
Last Update Date | 08/15/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 818 ORANGE AVE
-----------------------------------------------------
City | FORT PIERCE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34950-4185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-588-2277
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 432 NW CORNELL AVE
-----------------------------------------------------
City | PORT ST LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34983-1114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-410-6039
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | JDEANNIE JOSEPH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 772-410-6039
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------