Provider Demographics
NPI:1790155109
Name:INDIAN RIVER HOME CARE PLUS
Entity Type:Organization
Organization Name:INDIAN RIVER HOME CARE PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:J
Authorized Official - Last Name:KORNICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-569-3885
Mailing Address - Street 1:65 ROYAL PALM PT
Mailing Address - Street 2:SUITE F
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4259
Mailing Address - Country:US
Mailing Address - Phone:772-569-3885
Mailing Address - Fax:772-569-3886
Practice Address - Street 1:65 ROYAL PALM PT
Practice Address - Street 2:SUITE F
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4259
Practice Address - Country:US
Practice Address - Phone:772-569-3885
Practice Address - Fax:772-569-3886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health