Provider Demographics
NPI:1356498372
Name:RECOVERY HOME CARE, INC
Entity Type:Organization
Organization Name:RECOVERY HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:GINNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SKULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-200-2760
Mailing Address - Street 1:544 NW UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2283
Mailing Address - Country:US
Mailing Address - Phone:772-200-2760
Mailing Address - Fax:772-200-2760
Practice Address - Street 1:580 VILLAGE BLVD.
Practice Address - Street 2:SUITE 120
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:561-688-1915
Practice Address - Fax:561-688-9021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991206251E00000X
FL299991581251E00000X
FL299991378251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107619Medicare Oscar/Certification
107619Medicare ID - Type Unspecified