Provider Demographics
NPI:1386830008
Name:360 HOME CARE, INC.
Entity Type:Organization
Organization Name:360 HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:
Authorized Official - Last Name:MELINU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-457-2983
Mailing Address - Street 1:801 MADRID ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2283
Mailing Address - Country:US
Mailing Address - Phone:305-448-3461
Mailing Address - Fax:305-448-3462
Practice Address - Street 1:801 MADRID ST
Practice Address - Street 2:SUITE 211
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2283
Practice Address - Country:US
Practice Address - Phone:305-448-3461
Practice Address - Fax:305-448-3462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-16
Last Update Date:2007-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992640251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299992640OtherAHCA