Provider Demographics
NPI:1811950934
Name:ST. CATHERINE'S HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:ST. CATHERINE'S HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MADELEIN
Authorized Official - Middle Name:FERNANDEZ
Authorized Official - Last Name:WHITT
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:305-556-6997
Mailing Address - Street 1:15271 NW 60TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2422
Mailing Address - Country:US
Mailing Address - Phone:305-556-6997
Mailing Address - Fax:305-557-9558
Practice Address - Street 1:15271 NW 60TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2422
Practice Address - Country:US
Practice Address - Phone:305-556-6997
Practice Address - Fax:305-557-9558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299992048251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651194501Medicaid
FL651194500Medicaid
FL651194501Medicaid