Provider Demographics
NPI:1598990988
Name:NANNIES4GRANNIES
Entity Type:Organization
Organization Name:NANNIES4GRANNIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JULES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-900-6055
Mailing Address - Street 1:PO BOX 666954
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33066-6954
Mailing Address - Country:US
Mailing Address - Phone:561-900-6055
Mailing Address - Fax:
Practice Address - Street 1:2700 W ATLANTIC BLVD STE 240
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-5722
Practice Address - Country:US
Practice Address - Phone:561-900-6055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230446251V00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251V00000XAgenciesVoluntary or Charitable