Provider Demographics
NPI:1194902361
Name:HOME SWEET HOME CARE FACILITY CORP.
Entity type:Organization
Organization Name:HOME SWEET HOME CARE FACILITY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-571-2135
Mailing Address - Street 1:5341 EAST 5 AVENUE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1546
Mailing Address - Country:US
Mailing Address - Phone:786-359-4429
Mailing Address - Fax:305-675-3117
Practice Address - Street 1:5341 EAST 5 AVENUE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1546
Practice Address - Country:US
Practice Address - Phone:786-359-4429
Practice Address - Fax:305-675-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9862310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL680281800Medicaid
FL024457700Medicaid
FL140437700Medicaid