Provider Demographics
NPI:1154896124
Name:HOME SUITEHOME LLC
Entity type:Organization
Organization Name:HOME SUITEHOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHELIHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-379-6433
Mailing Address - Street 1:18629 LOCHPOINT CT
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3866
Mailing Address - Country:US
Mailing Address - Phone:561-379-6433
Mailing Address - Fax:561-828-3100
Practice Address - Street 1:9286 BIRMINGHAM DR
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5924
Practice Address - Country:US
Practice Address - Phone:561-318-6177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility