MEDICARE: COMPLETE HOME CARE OF BROWARD, INC DBA HOSPITAL WITHOUT WALLS

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

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	:	1609032663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE HOME CARE OF BROWARD, INC DBA HOSPITAL WITHOUT WALLS

Provider Business Mailing Address
First Line	:	2310 NW 3RD AVE STE 8
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-4963
Country	:	US
Telephone Number	:	954-642-3417
Fax Number	:	954-642-3817

Provider Business Practice Location Address
First Line	:	2310 NW 3RD AVE STE 8
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-4963
Country	:	US
Telephone Number	:	954-642-3417
Fax Number	:	954-642-3818

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BAHER F HABIB
Credential	:	RPT
Telephone Number	:	561-436-9595

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	07/30/2008

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