Provider Demographics
NPI:1962633792
Name:PACKPLUS, INC.
Entity Type:Organization
Organization Name:PACKPLUS, INC.
Other - Org Name:JOSMAR HOMEMAKER COMPANION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:OBADEYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-653-2880
Mailing Address - Street 1:633 NE 167TH ST
Mailing Address - Street 2:SUITE 620
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-2442
Mailing Address - Country:US
Mailing Address - Phone:305-653-2880
Mailing Address - Fax:305-653-2881
Practice Address - Street 1:633 NE 167TH ST
Practice Address - Street 2:SUITE 620
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2442
Practice Address - Country:US
Practice Address - Phone:305-653-2880
Practice Address - Fax:305-653-2881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229882253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL692117596OtherMEDICAID HCBS WAIVER
FL692060800OtherMEDICAID AGING AND DISABLED ADULTS WAIVER
FL692117598OtherMEDICAID FSL WAIVER