1548694144 NPI number — EMMANUEL CATALYST HHA LP

Table of content: (NPI 1548694144)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548694144 NPI number — EMMANUEL CATALYST HHA LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMMANUEL CATALYST HHA LP
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:
EMMANUEL CATALYST HHA
Provider Other Organization Name Type Code:
3
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:
1548694144
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1975 E SUNRISE BLVD
Provider Second Line Business Mailing Address:
SUITE 521
Provider Business Mailing Address City Name:
FORT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33304-1433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-441-3379
Provider Business Mailing Address Fax Number:
888-673-6396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
255 NW 124TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33168-3613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-385-3451
Provider Business Practice Location Address Fax Number:
888-673-6396
Provider Enumeration Date:
08/30/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
POINTDUJOUR
Authorized Official First Name:
PIERRE
Authorized Official Middle Name:
CHARLY
Authorized Official Title or Position:
CEO/ADMINISTRATOR
Authorized Official Telephone Number:
708-238-3585

Provider Taxonomy Codes

  • Taxonomy code: 302F00000X , with the licence number:  39968028 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 302F00000X , with the licence number: 3000730 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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