Provider Demographics
NPI:1396924932
Name:SPECIAL CARE HOME HEALTH AGENCY, INC.
Entity type:Organization
Organization Name:SPECIAL CARE HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAIDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LA O RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTER NURSE
Authorized Official - Phone:305-266-0966
Mailing Address - Street 1:7401 NW 7TH ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2945
Mailing Address - Country:US
Mailing Address - Phone:305-266-0966
Mailing Address - Fax:305-266-0967
Practice Address - Street 1:7401 NW 7TH ST
Practice Address - Street 2:UNIT 2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2945
Practice Address - Country:US
Practice Address - Phone:305-266-0966
Practice Address - Fax:305-266-0967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992895251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health