Provider Demographics
NPI:1952386914
Name:DISTINGUISHED HOME HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:DISTINGUISHED HOME HEALTH CARE SERVICES, INC.
Other - Org Name:ASSOCIATED HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-987-2445
Mailing Address - Street 1:11011 SHERIDAN STREET
Mailing Address - Street 2:SUITE 206
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33026-1531
Mailing Address - Country:US
Mailing Address - Phone:954-987-2445
Mailing Address - Fax:954-987-2446
Practice Address - Street 1:11011 SHERIDAN STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33026-1531
Practice Address - Country:US
Practice Address - Phone:954-987-2445
Practice Address - Fax:954-987-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991811251E00000X
FL299991811251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108097Medicare PIN