Provider Demographics
NPI:1063492387
Name:CATHOLIC HOME HEALTH SERVICES OF BROWARD INC
Entity type:Organization
Organization Name:CATHOLIC HOME HEALTH SERVICES OF BROWARD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:SONIA
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-486-3660
Mailing Address - Street 1:14875 NW 77TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2565
Mailing Address - Country:US
Mailing Address - Phone:305-899-0400
Mailing Address - Fax:305-899-0769
Practice Address - Street 1:14875 NW 77TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2565
Practice Address - Country:US
Practice Address - Phone:305-899-0400
Practice Address - Fax:305-899-0769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21233096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650955000Medicaid
FL107670Medicare ID - Type Unspecified