Provider Demographics
NPI:1457090144
Name:INTERIM HEALTHCARE OF TREASURE COAST, INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF TREASURE COAST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER PRIVATE DUTY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCGOLDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-616-9500
Mailing Address - Street 1:2 HARVARD CIR STE 950
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1994
Mailing Address - Country:US
Mailing Address - Phone:561-616-9500
Mailing Address - Fax:561-616-9909
Practice Address - Street 1:6905 LTC PKWY
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-3947
Practice Address - Country:US
Practice Address - Phone:772-410-5624
Practice Address - Fax:561-616-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health