Provider Demographics
NPI:1568764348
Name:ATLANTIC HOME CARE, LLC
Entity Type:Organization
Organization Name:ATLANTIC HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACKELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PLACENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:954-363-1363
Mailing Address - Street 1:2415 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5123
Mailing Address - Country:US
Mailing Address - Phone:954-363-1363
Mailing Address - Fax:888-896-6607
Practice Address - Street 1:2425 N. UNIVERSITY DRIVE
Practice Address - Street 2:SUITE 2415
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-363-1363
Practice Address - Fax:888-896-6607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care