Provider Demographics
NPI:1114023678
Name:INTERIM HEALTHCARE OF TREASURE COAST, INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF TREASURE COAST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL AND CHIEF COMPLIANC
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:MCGILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-526-8446
Mailing Address - Street 1:2 HARVARD CIR
Mailing Address - Street 2:SUITE 950
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1988
Mailing Address - Country:US
Mailing Address - Phone:561-616-9500
Mailing Address - Fax:561-616-9909
Practice Address - Street 1:2 HARVARD CIR
Practice Address - Street 2:SUITE 950
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1988
Practice Address - Country:US
Practice Address - Phone:561-616-9500
Practice Address - Fax:561-616-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20567096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107237Medicare Oscar/Certification