MEDICARE: A ONE HOME CARE

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		FL

General Provider Information

NPI Number	:	1811286826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A ONE HOME CARE

Provider Business Mailing Address
First Line	:	3130 SW 19TH ST
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-2037
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3130 SW 19TH ST
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-2037
Country	:	US
Telephone Number	:	786-457-8232
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. JENNIFER ELAINE DECARISH
Credential	:
Telephone Number	:	786-457-8232

Provider Enumeration Date	:	03/30/2011
Last Update Date	:	03/30/2011

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