MEDICARE: SACRED HEART HOME HEALTH, 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	372600000X	Adult Companion
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1831954551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACRED HEART HOME HEALTH, LLC

Provider Business Mailing Address
First Line	:	4000 N STATE ROAD 7 STE 409B
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-4882
Country	:	US
Telephone Number	:	954-348-2430
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 N STATE ROAD 7 STE 409B
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-4882
Country	:	US
Telephone Number	:	954-348-2430
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MICHELLE BLAKE
Credential	:
Telephone Number	:	945-348-2430

Provider Enumeration Date	:	02/21/2024
Last Update Date	:	02/26/2025

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