MEDICARE: RELIABLE HOME CARE SUPPORT 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	3747P1801X	Personal Care Attendant
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1942704457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIABLE HOME CARE SUPPORT LLC

Provider Business Mailing Address
First Line	:	5741 PEMBROKE RD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33023-2337
Country	:	US
Telephone Number	:	954-696-4010
Fax Number	:	954-272-7343

Provider Business Practice Location Address
First Line	:	5741 PEMBROKE RD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33023-2337
Country	:	US
Telephone Number	:	954-696-4010
Fax Number	:	954-272-7343

Authorized Official
Title or Position	:	OWNER
Name	:	EMMANUEL TOUZE
Credential	:
Telephone Number	:	954-696-4010

Provider Enumeration Date	:	03/20/2018
Last Update Date	:	02/07/2022

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