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General NPI Number Information
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NPI Number | 1740996206
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Entity Type | Organization
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Legal Business Name | ETTERAM HOME CARE LLC
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Dates
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Enumeration Date | 01/27/2023
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 1110 NW 136TH ST
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City | MIAMI
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State | FL
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Zip | 33168-6733
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Country | US
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Telephone | 631-452-6223
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Fax |
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Provider Business Mailing Address
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Address Line | 92 EMPRESS PINES DR
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City | NESCONSET
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State | NY
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Zip | 11767-3130
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Country | US
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Telephone | 631-452-6223
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | EXCHING-CHINELLEE MARETTE JOSUE
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Credential |
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Telephone | 631-452-6223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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