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General NPI Number Information
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NPI Number | 1811227580
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Entity Type | Organization
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Legal Business Name | STAY AT HOME CAREGIVERS, INC.
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Dates
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Enumeration Date | 01/02/2010
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Last Update Date | 01/02/2010
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Provider Practice Location Address
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Address Line | 6625 MIAMI LAKES DR SUITE #404
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2708
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Country | US
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Telephone | 305-777-3809
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Fax | 954-236-3289
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Provider Business Mailing Address
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Address Line | 481 SUMTER AVE
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City | DAVIE
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State | FL
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Zip | 33325-6350
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Country | US
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Telephone | 305-777-3809
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Fax | 954-236-3289
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CORALIA MARIA JENNINGS
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Credential | M.P.A., C.N.A.
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Telephone | 305-777-3809
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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 | 231499
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License Number State | FL
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