1699778647 NPI number — VISITING HOME HEALTH SERVICES, INC

Table of content: (NPI 1699778647)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699778647 NPI number — VISITING HOME HEALTH SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
N/A
Provider Organization Name:
VISITING HOME HEALTH SERVICES, 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:
LIFE CARE AT HOME
Provider Other Organization Name Type Code:
5
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:
1699778647
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3001 KEITH ST NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37312-3713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-473-5256
Provider Business Mailing Address Fax Number:
423-559-8356

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4291 ROCK ISLAND RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAUDERHILL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33319-4509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-462-5582
Provider Business Practice Location Address Fax Number:
954-382-4316
Provider Enumeration Date:
05/23/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RAU
Authorized Official First Name:
PAM
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF FINANCE
Authorized Official Telephone Number:
423-473-5268

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA21236096 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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