MEDICARE: YOUR NURSE HOME HEALTHCARE, LLC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1487889895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR NURSE HOME HEALTHCARE, LLC.

Provider Business Mailing Address
First Line	:	7481 WEST OAKLAND PARK BLVD SUITE 203C
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33351
Country	:	US
Telephone Number	:	954-416-2372
Fax Number	:	954-416-2378

Provider Business Practice Location Address
First Line	:	7481 WEST OAKLAND PARK BLVD SUITE 203C
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33351
Country	:	US
Telephone Number	:	954-416-2372
Fax Number	:	954-416-2378

Authorized Official
Title or Position	:	OWNER
Name	:	MR. CHARLES KANTOR
Credential	:
Telephone Number	:	954-416-2372

Provider Enumeration Date	:	05/29/2009
Last Update Date	:	05/29/2009

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