Provider Demographics
NPI:1811082217
Name:BROWARD HOMEBOUND PROGRAM, INC.
Entity type:Organization
Organization Name:BROWARD HOMEBOUND PROGRAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-786-2484
Mailing Address - Street 1:201 E.SAMPLE ROAD
Mailing Address - Street 2:C/O NORTH BROWARD MEDICAL CENTER
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064
Mailing Address - Country:US
Mailing Address - Phone:954-786-2484
Mailing Address - Fax:954-786-2407
Practice Address - Street 1:3810 INVERRARY BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4356
Practice Address - Country:US
Practice Address - Phone:954-741-5373
Practice Address - Fax:954-677-3038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management