Provider Demographics
NPI:1235499567
Name:MATRIX HOME CARE
Entity Type:Organization
Organization Name:MATRIX HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PERNILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-471-2992
Mailing Address - Street 1:1801 CENTREPARK DR E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-7422
Mailing Address - Country:US
Mailing Address - Phone:561-471-2992
Mailing Address - Fax:561-471-2998
Practice Address - Street 1:1421 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-2801
Practice Address - Country:US
Practice Address - Phone:813-661-7100
Practice Address - Fax:813-661-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL200080096OtherAHCA LICENSE