Provider Demographics
NPI:1225123607
Name:HOME CARE SYSTEMS INC
Entity Type:Organization
Organization Name:HOME CARE SYSTEMS INC
Other - Org Name:MEDINURSE HOME CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. CLINICAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-826-7127
Mailing Address - Street 1:12855 SW 132ND ST STE 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7221
Mailing Address - Country:US
Mailing Address - Phone:305-826-7127
Mailing Address - Fax:305-823-0501
Practice Address - Street 1:12855 SW 132ND ST STE 206
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7221
Practice Address - Country:US
Practice Address - Phone:305-826-7127
Practice Address - Fax:305-823-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA20701096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650397703Medicaid
FL650397705Medicaid