Provider Demographics
NPI:1932361631
Name:CARESERVICES OF THE HEARTLAND LLC
Entity type:Organization
Organization Name:CARESERVICES OF THE HEARTLAND LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-244-0220
Mailing Address - Street 1:2400 HIGH RIDGE RD
Mailing Address - Street 2:SUITE 101 AND 103
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8725
Mailing Address - Country:US
Mailing Address - Phone:561-244-0220
Mailing Address - Fax:561-244-0221
Practice Address - Street 1:3710 CORPOREX PARK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-1189
Practice Address - Country:US
Practice Address - Phone:813-630-4336
Practice Address - Fax:813-864-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6509037-01251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650903701Medicaid