MEDICARE: RICHMOND HOME CARE, 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1679102008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMOND HOME CARE, INC.

Provider Business Mailing Address
First Line	:	13998 SW 159TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-1090
Country	:	US
Telephone Number	:	786-348-6566
Fax Number	:

Provider Business Practice Location Address
First Line	:	13998 SW 159TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-1090
Country	:	US
Telephone Number	:	786-348-6566
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMIN.
Name	:	LAMAY FERNANDEZ
Credential	:
Telephone Number	:	786-420-8093

Provider Enumeration Date	:	04/07/2020
Last Update Date	:	04/07/2020

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Directions to “RICHMOND HOME CARE, INC. ” Practice Location

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