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General NPI Number Information
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NPI Number | 1740450733
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Entity Type | Organization
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Legal Business Name | A SELECT GROUP HOME HEALTH CARE INC
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 4113 NW 135TH ST
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City | OPA LOCKA
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State | FL
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Zip | 33054-4615
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Country | US
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Telephone | 305-477-6603
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Fax | 305-477-6605
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Provider Business Mailing Address
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Address Line | 4113 NW 135TH ST
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City | OPA LOCKA
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State | FL
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Zip | 33054-4615
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Country | US
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Telephone | 305-477-6603
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Fax | 305-477-6605
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MIGUEL A PEREZ
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Credential |
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Telephone | 305-477-6603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299992769
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License Number State | FL
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