Provider Demographics
NPI:1336689579
Name:EDOUARD HOME HEALTH INSTITUTE AND TRAINING CENTER INC
Entity Type:Organization
Organization Name:EDOUARD HOME HEALTH INSTITUTE AND TRAINING CENTER INC
Other - Org Name:EDOUARD HOME CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KINSONN
Authorized Official - Middle Name:J
Authorized Official - Last Name:EDOUARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-274-9818
Mailing Address - Street 1:2908 N ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33311-2516
Mailing Address - Country:US
Mailing Address - Phone:954-274-9818
Mailing Address - Fax:
Practice Address - Street 1:2908 N ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-2516
Practice Address - Country:US
Practice Address - Phone:954-274-9818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234725253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care