Provider Demographics
NPI:1265801468
Name:HOME HEALTH SERVICES OF SOUTHEAST FLORIDA LLC
Entity type:Organization
Organization Name:HOME HEALTH SERVICES OF SOUTHEAST FLORIDA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NELMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:561-672-8333
Mailing Address - Street 1:8983 OKEECHOBEE BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:561-672-8333
Mailing Address - Fax:844-848-5798
Practice Address - Street 1:8983 OKEECHOBEE BLVD STE 214
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:561-672-8333
Practice Address - Fax:844-848-5798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211755251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health