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General NPI Number Information
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NPI Number | 1861943912
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Entity Type | Organization
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Legal Business Name | FIRSTLANTIC HEALTHCARE
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 10/24/2016
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Provider Practice Location Address
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Address Line | 2605 W ATLANTIC AVE A202
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City | DELRAY BEACH
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State | FL
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Zip | 33445-4413
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Country | US
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Telephone | 561-243-7979
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Fax |
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Provider Business Mailing Address
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Address Line | 2605 W ATLANTIC AVE A202
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City | DELRAY BEACH
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State | FL
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Zip | 33445-4413
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Country | US
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Telephone | 561-243-7979
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Fax |
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Authorized Official
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Title or Position | FINANCE MANAGER
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Name | CINDY A BROWN
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Credential |
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Telephone | 561-243-7979
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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 | 20157096
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License Number State | FL
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