Provider Demographics
NPI:1710159637
Name:GLADES HOME HEALTH CARE MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:GLADES HOME HEALTH CARE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:ESTEVEZ
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-906-2612
Mailing Address - Street 1:173 W AVENUE A
Mailing Address - Street 2:
Mailing Address - City:BELLE GLADE
Mailing Address - State:FL
Mailing Address - Zip Code:33430-3098
Mailing Address - Country:US
Mailing Address - Phone:561-996-2220
Mailing Address - Fax:561-996-2228
Practice Address - Street 1:173 W AVENUE A
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-3098
Practice Address - Country:US
Practice Address - Phone:561-996-2220
Practice Address - Fax:561-996-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993085251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health