Provider Demographics
NPI:1689643652
Name:VISITING HOMEMAKER SERVICES
Entity Type:Organization
Organization Name:VISITING HOMEMAKER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-473-5268
Mailing Address - Street 1:3001 KEITH ST NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3713
Mailing Address - Country:US
Mailing Address - Phone:423-473-5256
Mailing Address - Fax:423-339-8356
Practice Address - Street 1:4291 ROCK ISLAND RD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4509
Practice Address - Country:US
Practice Address - Phone:954-423-2273
Practice Address - Fax:954-423-3654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL212237095251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID