Provider Demographics
NPI:1003833971
Name:PRIME HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:PRIME HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESPERANZA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-477-2037
Mailing Address - Street 1:4815 NW 79TH AVE
Mailing Address - Street 2:#17
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5437
Mailing Address - Country:US
Mailing Address - Phone:305-477-2037
Mailing Address - Fax:305-477-2097
Practice Address - Street 1:4815 NW 79TH AVE
Practice Address - Street 2:#17
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5437
Practice Address - Country:US
Practice Address - Phone:305-477-2037
Practice Address - Fax:305-477-2097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992396251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health