Provider Demographics
NPI:1114656709
Name:THERMIDOR HOME CARE AGENCY
Entity Type:Organization
Organization Name:THERMIDOR HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DHAITI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-338-5457
Mailing Address - Street 1:20283 STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6901
Mailing Address - Country:US
Mailing Address - Phone:707-338-5457
Mailing Address - Fax:
Practice Address - Street 1:20283 STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6901
Practice Address - Country:US
Practice Address - Phone:707-338-5457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherPRIVATE PAY, CREDIT CARD, PRIVATE INSURANCE,