Provider Demographics
NPI:1184858193
Name:GOD BLESS HOME HEALTH
Entity type:Organization
Organization Name:GOD BLESS HOME HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-348-8705
Mailing Address - Street 1:6941 NW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5320
Mailing Address - Country:US
Mailing Address - Phone:954-348-8705
Mailing Address - Fax:
Practice Address - Street 1:950 S PINE ISLAND RD
Practice Address - Street 2:SUITE 150, UNIT 1019
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324
Practice Address - Country:US
Practice Address - Phone:954-342-9824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOD'S BLESS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-05
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL228483251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL685527098Medicaid
FL112751100Medicaid
FL685527096Medicaid