Provider Demographics
NPI:1225668387
Name:MEHONACARE LLC
Entity Type:Organization
Organization Name:MEHONACARE LLC
Other - Org Name:MEHONACARE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCHARD-MESADIEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-215-2399
Mailing Address - Street 1:2405 QUANTUM BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8612
Mailing Address - Country:US
Mailing Address - Phone:561-215-3468
Mailing Address - Fax:
Practice Address - Street 1:2405 QUANTUM BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8612
Practice Address - Country:US
Practice Address - Phone:561-215-3468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care