Provider Demographics
NPI:1215279559
Name:YENEICE GROUP HOME AND COMPANION SERVICES
Entity type:Organization
Organization Name:YENEICE GROUP HOME AND COMPANION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:P/T
Authorized Official - Prefix:MRS
Authorized Official - First Name:YENEICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:786-230-6437
Mailing Address - Street 1:7595 SW 152ND AVE APT H105
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2371
Mailing Address - Country:US
Mailing Address - Phone:786-230-6437
Mailing Address - Fax:
Practice Address - Street 1:7595 SW 152ND AVE APT H105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-2371
Practice Address - Country:US
Practice Address - Phone:786-230-6437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233003251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL233003Medicaid