Provider Demographics
NPI:1851513998
Name:GRANNY'S HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:GRANNY'S HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-887-1123
Mailing Address - Street 1:8323 NW 12TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1829
Mailing Address - Country:US
Mailing Address - Phone:305-887-1123
Mailing Address - Fax:305-559-6043
Practice Address - Street 1:8323 NW 12TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1829
Practice Address - Country:US
Practice Address - Phone:305-887-1123
Practice Address - Fax:305-559-6043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992743251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health