Provider Demographics
NPI:1558485722
Name:MORSELIFE HOME CARE INC.
Entity Type:Organization
Organization Name:MORSELIFE HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOWALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:561-616-0707
Mailing Address - Street 1:4920 LORING DRIVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417
Mailing Address - Country:US
Mailing Address - Phone:561-616-0707
Mailing Address - Fax:561-616-9106
Practice Address - Street 1:4920 LORING DRIVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417
Practice Address - Country:US
Practice Address - Phone:561-616-0707
Practice Address - Fax:561-616-9106
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORSELIFE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-16
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21179096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105801Medicare Oscar/Certification
FL109289Medicare PIN