Provider Demographics
NPI:1669644134
Name:STATEWIDE HOME HEALTHCARE,INC.
Entity Type:Organization
Organization Name:STATEWIDE HOME HEALTHCARE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:A
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-446-0616
Mailing Address - Street 1:275 FONTAINEBLEAU BLVD
Mailing Address - Street 2:SUITE 160B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4574
Mailing Address - Country:US
Mailing Address - Phone:305-446-0616
Mailing Address - Fax:305-226-1561
Practice Address - Street 1:275 FONTAINEBLEAU BLVD
Practice Address - Street 2:SUITE 160B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4574
Practice Address - Country:US
Practice Address - Phone:305-446-0616
Practice Address - Fax:305-226-1561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health