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General NPI Number Information
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NPI Number | 1699532440
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Entity Type | Organization
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Legal Business Name | VIKE HOME CARE, LLC
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 1871 W OAKLAND PARK BLVD STE W-B
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1517
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Country | US
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Telephone | 954-716-5271
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Fax | 954-572-1454
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Provider Business Mailing Address
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Address Line | 1871 W OAKLAND PARK BLVD STE W-B
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1517
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Country | US
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Telephone | 954-716-5271
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Fax | 954-572-1454
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Authorized Official
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Title or Position | PRESIDENT
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Name | KETLYNE ANTOINE
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Credential | LPN
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Telephone | 954-716-5271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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