1497423156 NPI number — AMELIE HOME CARE S, INC

Table of content: (NPI 1497423156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497423156 NPI number — AMELIE HOME CARE S, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMELIE HOME CARE S, 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:
1497423156
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1271 PEREGRINE WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33327-2372
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-687-6197
Provider Business Mailing Address Fax Number:
561-990-1332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2790 N UNIVERSITY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33024-2546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-404-8670
Provider Business Practice Location Address Fax Number:
561-990-1332
Provider Enumeration Date:
08/30/2021

Additional Information

Authorized Official

Authorized Official Last Name:
TOUSSAINT
Authorized Official First Name:
GERMAINE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/ADMIN/DON
Authorized Official Telephone Number:
954-687-6197

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: 115040200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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