Provider Demographics
NPI: | 1891004008 |
---|---|
Name: | UNLIMITED HOME HEALTH SERVICES CORP |
Entity Type: | Organization |
Organization Name: | UNLIMITED HOME HEALTH SERVICES CORP |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | PEDRO |
Authorized Official - Middle Name: | E |
Authorized Official - Last Name: | RODRIGUEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 239-425-2631 |
Mailing Address - Street 1: | 7370 COLLEGE PKWY |
Mailing Address - Street 2: | SUITE 205 |
Mailing Address - City: | FORT MYERS |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33907-5558 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 239-425-2631 |
Mailing Address - Fax: | 239-425-2633 |
Practice Address - Street 1: | 7370 COLLEGE PKWY |
Practice Address - Street 2: | 205 |
Practice Address - City: | FORT MYERS |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33907-5558 |
Practice Address - Country: | US |
Practice Address - Phone: | 239-425-2631 |
Practice Address - Fax: | 239-425-2633 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-10-05 |
Last Update Date: | 2014-11-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | 003759100 | Medicaid |