Provider Demographics
NPI:1700330255
Name:MOLINA HOME CARE INC.
Entity Type:Organization
Organization Name:MOLINA HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-906-0560
Mailing Address - Street 1:5918 BENT PINE DR
Mailing Address - Street 2:213
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-3338
Mailing Address - Country:US
Mailing Address - Phone:407-906-0560
Mailing Address - Fax:
Practice Address - Street 1:5918 BENT PINE DR
Practice Address - Street 2:213
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-3338
Practice Address - Country:US
Practice Address - Phone:407-906-0560
Practice Address - Fax:407-209-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities