Provider Demographics
NPI:1457859985
Name:HEAVENLY TOUCH HOME HEALTH CARE OF BROWARD CORP
Entity Type:Organization
Organization Name:HEAVENLY TOUCH HOME HEALTH CARE OF BROWARD CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IBIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:TEJEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-406-3648
Mailing Address - Street 1:3350 SW 148 AVE
Mailing Address - Street 2:STE-110 / OFFICE-103
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3257
Mailing Address - Country:US
Mailing Address - Phone:305-406-3648
Mailing Address - Fax:305-406-3649
Practice Address - Street 1:3350 SW 148 AVE
Practice Address - Street 2:STE-110 / OFFICE-103
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3257
Practice Address - Country:US
Practice Address - Phone:305-406-3648
Practice Address - Fax:305-406-3649
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEAVENLY TOUCH HOME HEALTH CARE, CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health