=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710503701
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TIMELESS HEALTHCARE SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2020
-----------------------------------------------------
Last Update Date | 06/25/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2054 VISTA PKWY STE 400
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33411-6742
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-214-0321
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2054 VISTA PKWY STE 400
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33411-6742
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-214-0321
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | FRANCOISE BLACK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 561-475-4100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------