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General NPI Number Information
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NPI Number | 1659512721
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Entity Type | Organization
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Legal Business Name | MCJ HOMEMAKER AND COMPANION SERVICES LLC
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 03/24/2009
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Provider Practice Location Address
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Address Line | 14434 SW 293RD TER
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City | HOMESTEAD
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State | FL
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Zip | 33033-2953
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Country | US
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Telephone | 786-547-9454
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Fax | 305-245-0980
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Provider Business Mailing Address
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Address Line | 12355 SW 259TH TER
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City | HOMESTEAD
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State | FL
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Zip | 33032-7073
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Country | US
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Telephone | 786-547-9454
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Fax | 305-245-0980
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Authorized Official
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Title or Position | MGRM
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Name | MS. MARIA DEL CARMEN JEREZ
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Credential |
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Telephone | 786-547-9454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | L07000062465
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number | L07000062465
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number | L07000062435
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | L07000062435
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number | L07000062435
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | L07000062435
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License Number State | FL
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