Provider Demographics
NPI:1598743411
Name:MS HOMECARE CORP
Entity Type:Organization
Organization Name:MS HOMECARE CORP
Other - Org Name:HOME ADVANATGE - PRIVATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANNETTE
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-948-1700
Mailing Address - Street 1:18441 NW 2ND AVE STE 216A
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4517
Mailing Address - Country:US
Mailing Address - Phone:305-948-1700
Mailing Address - Fax:305-948-1711
Practice Address - Street 1:18441 NW 2ND AVE STE 216A
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4517
Practice Address - Country:US
Practice Address - Phone:305-948-1700
Practice Address - Fax:305-948-1711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA20475096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108177Medicare Oscar/Certification