Provider Demographics
NPI:1235914383
Name:PROCARE SENIOR HOMEHEALTH LLC
Entity Type:Organization
Organization Name:PROCARE SENIOR HOMEHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KNEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-253-9093
Mailing Address - Street 1:12555 ORANGE DR STE 275
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4304
Mailing Address - Country:US
Mailing Address - Phone:954-862-1409
Mailing Address - Fax:954-337-3135
Practice Address - Street 1:12555 ORANGE DR STE 275
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4304
Practice Address - Country:US
Practice Address - Phone:954-862-1409
Practice Address - Fax:954-337-3135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health