Provider Demographics
NPI:1821352063
Name:HOMEWOOD HOME HEALTH LLC
Entity Type:Organization
Organization Name:HOMEWOOD HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PAREL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:954-973-3800
Mailing Address - Street 1:6894 LAKE WORTH RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2964
Mailing Address - Country:US
Mailing Address - Phone:561-275-7500
Mailing Address - Fax:561-275-7575
Practice Address - Street 1:6894 LAKE WORTH RD
Practice Address - Street 2:SUITE 207
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2964
Practice Address - Country:US
Practice Address - Phone:561-275-7500
Practice Address - Fax:561-275-7575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMEWOOD HOME HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993841251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299993841OtherAGENCY FOR HEALTH CARE ADMINISTRATION