Provider Demographics
NPI:1780622118
Name:MVG, INC. DBA ENERY HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:MVG, INC. DBA ENERY HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-468-9350
Mailing Address - Street 1:6475 SW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3955
Mailing Address - Country:US
Mailing Address - Phone:305-662-6413
Mailing Address - Fax:
Practice Address - Street 1:7705 NW 29TH ST
Practice Address - Street 2:SUITE 103-A
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1102
Practice Address - Country:US
Practice Address - Phone:305-468-9350
Practice Address - Fax:305-468-9352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA20327096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650960600Medicaid
FL650960602Medicaid
FL650960679Medicaid
FL108073Medicare ID - Type UnspecifiedFLORIDA MEDICARE