MEDICARE: HOMEGROWN HEALTHCARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	133NN1002X	Nutrition Education Nutritionist
4	174200000X	Meals Provider
5	208100000X	Physical Medicine & Rehabilitation Physician
6	225100000X	Physical Therapist
7	225800000X	Recreation Therapist
8	225A00000X	Music Therapist
9	261QA0600X	Adult Day Care Clinic/Center
10	261QA0900X	Amputee Clinic/Center
11	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
12	261QR0400X	Rehabilitation Clinic/Center
13	261QM1300X	Multi-Specialty Clinic/Center
14	261QP2000X	Physical Therapy Clinic/Center
15	335G00000X	Medical Foods Supplier

General Provider Information

NPI Number	:	1477487742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMEGROWN HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	2709 NE 34TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1519
Country	:	US
Telephone Number	:	954-605-5371
Fax Number	:

Provider Business Practice Location Address
First Line	:	2709 NE 34TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1519
Country	:	US
Telephone Number	:	954-605-5371
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. WILLIAM BLACK WARD JR.
Credential	:	MD
Telephone Number	:	954-605-5371

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “HOMEGROWN HEALTHCARE, LLC ” Practice Location

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