MEDICARE: HOME HEALTH AGENCY-PALM BEACHES, 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	299991617	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558355396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME HEALTH AGENCY-PALM BEACHES, LLC

Provider Business Mailing Address
First Line	:	510 HOSPITAL DR
Second Line	:	SUITE 150
City	:	MADISON
State	:	TN
Zip	:	37115-5033
Country	:	US
Telephone Number	:	615-627-9267
Fax Number	:	615-577-0811

Provider Business Practice Location Address
First Line	:	8198 S JOG RD
Second Line	:	SUITE 101
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-2900
Country	:	US
Telephone Number	:	561-244-6055
Fax Number	:	561-244-6085

Authorized Official
Title or Position	:	DIRECTOR OF LICENSING/ACCREDITATION
Name	:	AMANDA MCFADDIN
Credential	:	BSHCM
Telephone Number	:	615-712-2250

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	11/20/2012

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