Provider Demographics
NPI:1326367681
Name:PATIENT CARE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:PATIENT CARE HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:F
Authorized Official - Last Name:VALENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-299-0202
Mailing Address - Street 1:1489 W PALMETTO PARK RD
Mailing Address - Street 2:SUITE NO 390
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-3325
Mailing Address - Country:US
Mailing Address - Phone:561-372-7185
Mailing Address - Fax:561-372-7188
Practice Address - Street 1:1489 W PALMETTO PARK RD
Practice Address - Street 2:SUITE NO 390
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-3325
Practice Address - Country:US
Practice Address - Phone:561-372-7185
Practice Address - Fax:561-372-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993700314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility