Provider Demographics
NPI:1679901185
Name:SHC HOME HEALTH SERVICES - JENSEN BEACH, LLC
Entity Type:Organization
Organization Name:SHC HOME HEALTH SERVICES - JENSEN BEACH, LLC
Other - Org Name:SIGNATURE HOMENOW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-568-7800
Mailing Address - Street 1:759 SW FEDERAL HWY STE 300
Mailing Address - Street 2:ROYAL PALM FINANCIAL CENTER BLDG 3
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2923
Mailing Address - Country:US
Mailing Address - Phone:772-287-5111
Mailing Address - Fax:772-287-5115
Practice Address - Street 1:759 SW FEDERAL HWY STE 300
Practice Address - Street 2:ROYAL PALM FINANCIAL CENTER BLDG 3
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2923
Practice Address - Country:US
Practice Address - Phone:772-287-5111
Practice Address - Fax:772-287-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
108274Medicare Oscar/Certification