MEDICARE: ELDERCARE AT HOME, INC.

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	30211002	FL

General Provider Information

NPI Number	:	1518178862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELDERCARE AT HOME, INC.

Provider Business Mailing Address
First Line	:	2328 10TH AVE N #601
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6615
Country	:	US
Telephone Number	:	561-585-0400
Fax Number	:	561-585-0399

Provider Business Practice Location Address
First Line	:	2328 10TH AVE N #601
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6615
Country	:	US
Telephone Number	:	561-471-3122
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	ELAYNE FIORELLA FORGIE
Credential	:
Telephone Number	:	561-585-0400

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	10/28/2015

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