Provider Demographics
NPI:1588083703
Name:ALDACARE NURSING SERVICES LLC
Entity type:Organization
Organization Name:ALDACARE NURSING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTTS
Authorized Official - Suffix:
Authorized Official - Credentials:ARDMS, RVT, RDCS
Authorized Official - Phone:561-536-8664
Mailing Address - Street 1:10 FAIRWAY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1803
Mailing Address - Country:US
Mailing Address - Phone:888-717-4762
Mailing Address - Fax:561-258-0584
Practice Address - Street 1:10 FAIRWAY DR
Practice Address - Street 2:STE 104
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1812
Practice Address - Country:US
Practice Address - Phone:888-717-4762
Practice Address - Fax:561-258-0584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211635251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health