Provider Demographics
NPI:1497319867
Name:AMITY HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:AMITY HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLERIZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-461-6737
Mailing Address - Street 1:4685 VILLAS SANTORINI DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-5176
Mailing Address - Country:US
Mailing Address - Phone:561-461-6737
Mailing Address - Fax:850-852-0127
Practice Address - Street 1:745 US HWY 1 SUITE 301;302;309
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:561-461-6737
Practice Address - Fax:850-852-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000111222333Medicaid