Provider Demographics
NPI:1922115120
Name:PRO-LIFE HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:PRO-LIFE HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ADA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEYVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-388-4883
Mailing Address - Street 1:7401 NW 7TH STREET
Mailing Address - Street 2:UNIT 2
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2912
Mailing Address - Country:US
Mailing Address - Phone:786-388-4883
Mailing Address - Fax:305-269-0662
Practice Address - Street 1:7401 NW 7TH STREET
Practice Address - Street 2:UNIT 2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2912
Practice Address - Country:US
Practice Address - Phone:786-388-4883
Practice Address - Fax:305-269-0662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992016251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109231Medicare Oscar/Certification