Provider Demographics
NPI:1679847438
Name:W & J HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:W & J HOME HEALTH CARE INC
Other - Org Name:RIVERO HOMEMAKER COMPANION SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:RIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-352-6749
Mailing Address - Street 1:1146 E MOWRY DR
Mailing Address - Street 2:203
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-8184
Mailing Address - Country:US
Mailing Address - Phone:786-352-6749
Mailing Address - Fax:786-738-8220
Practice Address - Street 1:1146 E MOWRY DR
Practice Address - Street 2:203
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-8184
Practice Address - Country:US
Practice Address - Phone:786-352-6749
Practice Address - Fax:786-738-8220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-26
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLREGISTRATION 232382251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCERTIFICATE 15729OtherAHCA HOME CARE UNIT