1346500857 NPI number — ELDER ALTERNATIVES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346500857 NPI number — ELDER ALTERNATIVES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELDER ALTERNATIVES, 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:
Provider Other Organization Name Type Code:
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:
1346500857
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 SW 3RD ST STE 108
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POMPANO BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33060-6944
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-338-2273
Provider Business Mailing Address Fax Number:
954-697-7897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 KNUTH RD STE 200G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOYNTON BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33436-4693
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-338-2273
Provider Business Practice Location Address Fax Number:
954-697-7897
Provider Enumeration Date:
05/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
BLANCHETTE
Authorized Official First Name:
RHONDA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/HOME HEALTH ADMINISTRATOR
Authorized Official Telephone Number:
561-338-2273

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  299993272 , 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)

  • Identifier: 299993861 . This is a "AGENCY FOR HEALTH CARE ADMINISTRATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 299993272 . This is a "AGENCY FOR HEALTH CARE ADMINISTRATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 686629800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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