Provider Demographics
NPI:1689982647
Name:HEALTHE HOME DELIVERED MEALS INC
Entity Type:Organization
Organization Name:HEALTHE HOME DELIVERED MEALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WENNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-975-9611
Mailing Address - Street 1:3606 S OCEAN BLVD
Mailing Address - Street 2:#204
Mailing Address - City:HIGHLAND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33487-3351
Mailing Address - Country:US
Mailing Address - Phone:954-975-9611
Mailing Address - Fax:954-974-8073
Practice Address - Street 1:6876 POWERLINE RD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2156
Practice Address - Country:US
Practice Address - Phone:954-975-9611
Practice Address - Fax:954-974-8073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNOS1616322332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080475401OtherMEDICAID WAIVER
FL080475400OtherMEDICAID WAIVER