Provider Demographics
NPI:1992477574
Name:J.R.O.A.D HOME HEALTH AGENCY, LLC
Entity type:Organization
Organization Name:J.R.O.A.D HOME HEALTH AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIZZUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-688-9342
Mailing Address - Street 1:1750 N UNIVERSITY DR STE 216
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8912
Mailing Address - Country:US
Mailing Address - Phone:954-688-9342
Mailing Address - Fax:754-229-6630
Practice Address - Street 1:1750 N UNIVERSITY DR STE 216
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8912
Practice Address - Country:US
Practice Address - Phone:954-688-9342
Practice Address - Fax:754-229-6630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1417418278OtherIN HOME SUPPORT