Provider Demographics
NPI:1760540009
Name:GREEN CROSS HOME CARE SERVICES, INC
Entity Type:Organization
Organization Name:GREEN CROSS HOME CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LA FORTUNE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:954-443-4427
Mailing Address - Street 1:8910 MIRAMAR PKWY STE 305
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4188
Mailing Address - Country:US
Mailing Address - Phone:954-443-4427
Mailing Address - Fax:954-443-4428
Practice Address - Street 1:12998 SW 33RD ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2805
Practice Address - Country:US
Practice Address - Phone:954-438-8779
Practice Address - Fax:954-438-7736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108299Medicare ID - Type UnspecifiedPROVIDER