Provider Demographics
NPI:1801444682
Name:THREE-SIXTY HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:THREE-SIXTY HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAJUELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-414-4349
Mailing Address - Street 1:12930 SW 128TH ST UNIT 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6038
Mailing Address - Country:US
Mailing Address - Phone:786-724-1400
Mailing Address - Fax:786-724-1401
Practice Address - Street 1:12930 SW 128TH ST UNIT 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6038
Practice Address - Country:US
Practice Address - Phone:786-724-1400
Practice Address - Fax:786-724-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care