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General NPI Number Information
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NPI Number | 1619102407
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Entity Type | Organization
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Legal Business Name | SOUTHEAST HOMECARE LLC
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Dates
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Enumeration Date | 05/21/2009
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 1200 NW 17TH AVE STE 10
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City | DELRAY BEACH
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State | FL
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Zip | 33445-2512
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Country | US
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Telephone | 561-819-6400
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Fax | 561-819-6401
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Provider Business Mailing Address
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Address Line | 1200 NW 17 AVENUE SUITE 10
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City | DELRAY BEACH
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State | FL
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Zip | 33445
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Country | US
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Telephone | 561-819-6400
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Fax | 561-819-6401
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | LINDA MENDEZ
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Credential |
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Telephone | 844-215-4264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA299992181
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License Number State | FL
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