Provider Demographics
NPI:1609035070
Name:ST. CLARA HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:ST. CLARA HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-683-9707
Mailing Address - Street 1:1000 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3353
Mailing Address - Country:US
Mailing Address - Phone:305-445-9966
Mailing Address - Fax:
Practice Address - Street 1:1000 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3353
Practice Address - Country:US
Practice Address - Phone:305-445-9966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health