Provider Demographics
NPI:1164584579
Name:HOME BOUND CARE, INC.
Entity Type:Organization
Organization Name:HOME BOUND CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANINA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:570-233-0602
Mailing Address - Street 1:340 NW 183RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4464
Mailing Address - Country:US
Mailing Address - Phone:305-652-3100
Mailing Address - Fax:305-652-1290
Practice Address - Street 1:340 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4464
Practice Address - Country:US
Practice Address - Phone:305-652-3100
Practice Address - Fax:305-652-1290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21994096251E00000X
251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107761Medicare PIN