Provider Demographics
NPI:1629598412
Name:ANDRES HOME CARE & NOTARY SERVICES INC
Entity Type:Organization
Organization Name:ANDRES HOME CARE & NOTARY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSING ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:CNA/HHA
Authorized Official - Phone:561-502-8159
Mailing Address - Street 1:PO BOX 3341
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33465-3341
Mailing Address - Country:US
Mailing Address - Phone:561-502-8159
Mailing Address - Fax:
Practice Address - Street 1:419 W MANGO ST
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-2836
Practice Address - Country:US
Practice Address - Phone:561-502-8159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20949374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty