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General NPI Number Information
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NPI Number | 1972209716
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Entity Type | Organization
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Legal Business Name | NICMOY HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 02/02/2023
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1 EAST BOWARD BVLD SUITE 700
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2642
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Country | US
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Telephone | 954-745-4966
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Fax |
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Provider Business Mailing Address
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Address Line | 1 EAST BOWARD BVLD SUITE 700
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301
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Country | US
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Telephone | 954-745-4966
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ILEENE PARKER-SMITH
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Credential |
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Telephone | 786-344-1057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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