Provider Demographics
NPI:1407041551
Name:CLP HOME HEALTH SERVICE, CORP
Entity Type:Organization
Organization Name:CLP HOME HEALTH SERVICE, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-718-4949
Mailing Address - Street 1:7805 CORAL WAY STE 116
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6539
Mailing Address - Country:US
Mailing Address - Phone:305-718-4949
Mailing Address - Fax:305-718-4984
Practice Address - Street 1:7805 CORAL WAY STE 116
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6539
Practice Address - Country:US
Practice Address - Phone:305-718-4949
Practice Address - Fax:305-718-4984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109100OtherMEDICARE PROVIDER