MEDICARE: ABC HOME CARE FACILITY #2

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1932898855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC HOME CARE FACILITY #2

Provider Business Mailing Address
First Line	:	1434 BRIAN WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-5414
Country	:	US
Telephone Number	:	561-317-4752
Fax Number	:

Provider Business Practice Location Address
First Line	:	1434 BRIAN WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-5414
Country	:	US
Telephone Number	:	561-317-4752
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARTINE JEAN-PAUL
Credential	:	RN
Telephone Number	:	561-317-4752

Provider Enumeration Date	:	05/05/2023
Last Update Date	:	05/05/2023

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