Provider Demographics
NPI:1417521576
Name:FLORIDA HOME SUPPORT CENTER LLC
Entity Type:Organization
Organization Name:FLORIDA HOME SUPPORT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINERA RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-524-0121
Mailing Address - Street 1:11820 MIRAMAR PKWY STE 217
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5818
Mailing Address - Country:US
Mailing Address - Phone:561-524-0121
Mailing Address - Fax:561-264-8969
Practice Address - Street 1:11820 MIRAMAR PKWY STE 217
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5818
Practice Address - Country:US
Practice Address - Phone:561-524-0121
Practice Address - Fax:561-264-8969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty