Provider Demographics
NPI:1023449808
Name:TOP CLASS HOME CARE SERVICES
Entity type:Organization
Organization Name:TOP CLASS HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PETGRAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-859-7265
Mailing Address - Street 1:127 NW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4115
Mailing Address - Country:US
Mailing Address - Phone:305-907-1513
Mailing Address - Fax:305-907-1513
Practice Address - Street 1:127 NW 4TH AVE
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4115
Practice Address - Country:US
Practice Address - Phone:305-907-1513
Practice Address - Fax:305-907-1513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233327253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care