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General NPI Number Information
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NPI Number | 1720874019
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Entity Type | Organization
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Legal Business Name | INTEGRATED HOME CARE LLC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 112 NW 14TH AVE
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City | DANIA BEACH
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State | FL
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Zip | 33004-2614
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Country | US
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Telephone | 954-681-2881
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Fax | 954-656-0194
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Provider Business Mailing Address
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Address Line | 11216 NW 7TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-7957
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Country | US
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Telephone | 954-681-2881
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Fax | 954-656-0194
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Authorized Official
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Title or Position | ADVANCED PRACTICE REGISTERED NURSE
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Name | HERBERT GOLDWIRE
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Credential | APRN
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Telephone | 954-681-2881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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