Provider Demographics
NPI:1932772639
Name:PALOMO HEALH CARE
Entity Type:Organization
Organization Name:PALOMO HEALH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARELY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RBT- 20-186850
Authorized Official - Phone:786-355-8663
Mailing Address - Street 1:130 LEE BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-6120
Mailing Address - Country:US
Mailing Address - Phone:786-355-8663
Mailing Address - Fax:
Practice Address - Street 1:130 LEE BLVD STE 2
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6120
Practice Address - Country:US
Practice Address - Phone:239-674-9310
Practice Address - Fax:786-490-2838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty