1285794206 NPI number — NEILI HOME HEALTH CARE AGENCY, INC.

Table of content: (NPI 1285794206)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285794206 NPI number — NEILI HOME HEALTH CARE AGENCY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEILI HOME HEALTH CARE AGENCY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEILI HOME HEALTH CARE AGENCY, INC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285794206
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10651 N KENDALL DR STE 219
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33176-1545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-621-7946
Provider Business Mailing Address Fax Number:
786-235-7498

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10651 N KENDALL DR STE 219
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33176-1545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-621-7946
Provider Business Practice Location Address Fax Number:
786-235-7498
Provider Enumeration Date:
12/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VEULENS
Authorized Official First Name:
NERY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
786-621-7946

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 651600900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".