Provider Demographics
NPI:1205082344
Name:ALTUS HOME HEALTH SERVICES, LLC.
Entity type:Organization
Organization Name:ALTUS HOME HEALTH SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-247-4995
Mailing Address - Street 1:3426 DUCK AVENUE
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040
Mailing Address - Country:US
Mailing Address - Phone:305-247-4995
Mailing Address - Fax:305-247-4996
Practice Address - Street 1:3426 DUCK AVENUE
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040
Practice Address - Country:US
Practice Address - Phone:305-247-4995
Practice Address - Fax:305-247-4996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109506Medicare Oscar/Certification