Provider Demographics
NPI:1275330557
Name:GREY SENIOR HOME SERVICES LLC
Entity type:Organization
Organization Name:GREY SENIOR HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEYANIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-487-8608
Mailing Address - Street 1:900 W 49TH ST STE 546
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3442
Mailing Address - Country:US
Mailing Address - Phone:786-241-2325
Mailing Address - Fax:
Practice Address - Street 1:900 W 49TH ST STE 546
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3442
Practice Address - Country:US
Practice Address - Phone:786-241-2325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30212908OtherAHCA