Provider Demographics
NPI:1184679318
Name:CATHOLIC HOME HEALTH SERVICES OF BROWARD INC
Entity Type:Organization
Organization Name:CATHOLIC HOME HEALTH SERVICES OF BROWARD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-486-3660
Mailing Address - Street 1:3075 NW 35TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1107
Mailing Address - Country:US
Mailing Address - Phone:954-486-3660
Mailing Address - Fax:954-486-0867
Practice Address - Street 1:3075 NW 35TH AVE
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33311-1107
Practice Address - Country:US
Practice Address - Phone:954-486-3660
Practice Address - Fax:954-486-0867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA202340961251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL027027000Medicaid
FL107110Medicare PIN