Provider Demographics
NPI:1922051259
Name:CARESERVICES OF THE PLATINUM COAST, LLC
Entity Type:Organization
Organization Name:CARESERVICES OF THE PLATINUM COAST, LLC
Other - Org Name:ALLIANCECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-244-0220
Mailing Address - Street 1:2500 QUANTUM LAKES DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8324
Mailing Address - Country:US
Mailing Address - Phone:561-244-0220
Mailing Address - Fax:516-244-0221
Practice Address - Street 1:3200 BAILEY LANE
Practice Address - Street 2:SUITE 105
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-8522
Practice Address - Country:US
Practice Address - Phone:239-436-3569
Practice Address - Fax:239-436-3747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
FLHHA#202660952251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651168600Medicaid
FL651168600Medicaid
FL651168600Medicaid