Provider Demographics
NPI:1164660486
Name:JESHUA RAFA HOME HEALTH SERVICE INC
Entity Type:Organization
Organization Name:JESHUA RAFA HOME HEALTH SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-599-7181
Mailing Address - Street 1:3900 NW 79TH AVE
Mailing Address - Street 2:SUITE 480
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6556
Mailing Address - Country:US
Mailing Address - Phone:305-599-7181
Mailing Address - Fax:305-599-1695
Practice Address - Street 1:3900 NW 79TH AVE
Practice Address - Street 2:SUITE 480
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6556
Practice Address - Country:US
Practice Address - Phone:305-599-7181
Practice Address - Fax:305-599-1695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health