Provider Demographics
NPI:1326273814
Name:AUTHENTIC HOME HEALTHCARE, LLC.
Entity Type:Organization
Organization Name:AUTHENTIC HOME HEALTHCARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-416-2371
Mailing Address - Street 1:1001 N FEDERAL HWY STE 322
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2425
Mailing Address - Country:US
Mailing Address - Phone:954-416-2371
Mailing Address - Fax:954-416-2380
Practice Address - Street 1:1001 N FEDERAL HWY STE 322
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2425
Practice Address - Country:US
Practice Address - Phone:954-416-2371
Practice Address - Fax:954-416-2380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health