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General NPI Number Information
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NPI Number | 1700330255
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Entity Type | Organization
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Legal Business Name | MOLINA HOME CARE INC.
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 08/24/2016
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Provider Practice Location Address
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Address Line | 5918 BENT PINE DR 213
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City | ORLANDO
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State | FL
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Zip | 32822-3338
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Country | US
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Telephone | 407-906-0560
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Fax | 407-209-0049
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Provider Business Mailing Address
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Address Line | 5918 BENT PINE DR 213
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City | ORLANDO
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State | FL
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Zip | 32822-3338
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Country | US
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Telephone | 407-906-0560
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MELISSA MOLINA
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Credential |
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Telephone | 407-906-0560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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