Provider Demographics
NPI:1780335323
Name:PASSIONATE CARE SERVICES LLC
Entity type:Organization
Organization Name:PASSIONATE CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-421-2494
Mailing Address - Street 1:5601 CORPORATE WAY STE 111
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2041
Mailing Address - Country:US
Mailing Address - Phone:561-421-2494
Mailing Address - Fax:
Practice Address - Street 1:5601 CORPORATE WAY STE 111
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2041
Practice Address - Country:US
Practice Address - Phone:561-421-2494
Practice Address - Fax:561-429-4504
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PASSIONATE CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-14
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104418600Medicaid