MEDICARE: FRESH HOME CARE SERVICES 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	:	1588409403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRESH HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	4675 MARTHA LOUISE DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-2903
Country	:	US
Telephone Number	:	347-773-8787
Fax Number	:

Provider Business Practice Location Address
First Line	:	4675 MARTHA LOUISE DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-2903
Country	:	US
Telephone Number	:	347-773-8787
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FRESNEL LAGUERRE
Credential	:
Telephone Number	:	347-773-8787

Provider Enumeration Date	:	07/01/2024
Last Update Date	:	07/01/2024

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