Provider Demographics
NPI:1184220295
Name:ALEXIS HOME CARE AGENCY,LLC
Entity Type:Organization
Organization Name:ALEXIS HOME CARE AGENCY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLACA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXIS PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-410-2142
Mailing Address - Street 1:3175 S CONGRESS AVE STE 305A
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2562
Mailing Address - Country:US
Mailing Address - Phone:561-633-5003
Mailing Address - Fax:
Practice Address - Street 1:3175 S CONGRESS AVE STE 305A
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2562
Practice Address - Country:US
Practice Address - Phone:561-633-5003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-05
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105911200Medicaid