Provider Demographics
NPI:1457329146
Name:HEALTHY AT HOME, INC.
Entity Type:Organization
Organization Name:HEALTHY AT HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILIAN
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:305-556-2943
Mailing Address - Street 1:900 W 49TH ST
Mailing Address - Street 2:SUITE 326
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3402
Mailing Address - Country:US
Mailing Address - Phone:305-556-2943
Mailing Address - Fax:305-556-0786
Practice Address - Street 1:900 W 49TH ST
Practice Address - Street 2:SUITE 326
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3402
Practice Address - Country:US
Practice Address - Phone:305-556-2943
Practice Address - Fax:305-556-0786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992106251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651182100Medicaid
FL108180Medicare ID - Type UnspecifiedHOME HEALTH AGENCY
FL=========Medicare UPIN