Provider Demographics
NPI:1275782674
Name:PROVIDERS WHO CARE HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:PROVIDERS WHO CARE HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:MARNETTE
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-643-1014
Mailing Address - Street 1:3200 N FEDERAL HWY
Mailing Address - Street 2:SUITE 206-22
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6035
Mailing Address - Country:US
Mailing Address - Phone:561-338-9388
Mailing Address - Fax:866-583-4558
Practice Address - Street 1:3200 N FEDERAL HWY
Practice Address - Street 2:SUITE 206-22
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6035
Practice Address - Country:US
Practice Address - Phone:561-206-6112
Practice Address - Fax:561-826-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993270251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299993270OtherAHCA