Provider Demographics
NPI:1467478057
Name:HIGHLITE HOME CARE, INC.
Entity Type:Organization
Organization Name:HIGHLITE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-492-2870
Mailing Address - Street 1:5700 N FEDERAL HWY
Mailing Address - Street 2:#2
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2600
Mailing Address - Country:US
Mailing Address - Phone:954-492-2870
Mailing Address - Fax:954-492-2871
Practice Address - Street 1:5700 N FEDERAL HWY
Practice Address - Street 2:#2
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-2600
Practice Address - Country:US
Practice Address - Phone:954-492-2870
Practice Address - Fax:954-492-2871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108372Medicare Oscar/Certification