Provider Demographics
NPI:1801762604
Name:DELICATE CARE GROUP HOME LLC
Entity type:Organization
Organization Name:DELICATE CARE GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMOY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOULBOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:BUSINESS ADMIN
Authorized Official - Phone:954-630-6909
Mailing Address - Street 1:892 MAJESTIC AVE
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-6014
Mailing Address - Country:US
Mailing Address - Phone:954-630-6909
Mailing Address - Fax:
Practice Address - Street 1:892 MAJESTIC AVE
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-6014
Practice Address - Country:US
Practice Address - Phone:954-630-6909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty