=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831406149
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEILI HOME HEALTH CARE AGENCY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2010
-----------------------------------------------------
Last Update Date | 09/08/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10651 N. KENDALL DR SUITE 219
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33176-1545
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-621-7946
-----------------------------------------------------
Fax | 786-235-7498
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10651 N. KENDALL DR SUITE 219
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33176-1545
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-621-7946
-----------------------------------------------------
Fax | 786-235-7498
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/ADMINISTRATOR
-----------------------------------------------------
Name | NERY VEULENS
-----------------------------------------------------
Credential | CEO
-----------------------------------------------------
Telephone | 786-621-7946
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 299992705
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------