DISTINCTIVE HOME CARE, LLC
Adult Care Home
Ft Lauderdale, Florida
Provider NPI: 1861676157
Organization Information:Organization Name: DISTINCTIVE HOME CARE, LLC
Practice Location:
6460 NW 5TH WAY FT LAUDERDALE, FL 33309 US
Tel: 954-727-9142 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
6460 NW 5TH WAY FT LAUDERDALE, FL 33309 US
Tel: 954-727-9142 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | FL | 30211309 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
PRIVATE DUTY/NURSE REGIST | 30211309 | FL | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin