Provider Demographics
NPI:1447201082
Name:EXCLUSIVE HOME CARE, INC .
Entity Type:Organization
Organization Name:EXCLUSIVE HOME CARE, INC .
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-225-1900
Mailing Address - Street 1:2450 SW 137TH AVE STE 228
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6332
Mailing Address - Country:US
Mailing Address - Phone:305-225-1900
Mailing Address - Fax:305-225-4055
Practice Address - Street 1:2450 SW 137TH AVE STE 228
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6332
Practice Address - Country:US
Practice Address - Phone:305-225-1900
Practice Address - Fax:305-225-4055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
FL20335095251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650402700Medicaid
FL01918304OtherAMERIGROUP
FL685906200Medicaid
FLFL054661OtherSIMPLY HEALTHCARE
FLP10001293649OtherSUNSHINE HEALTH