# GENOMA HOME HEALTH CARE AGENCY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972928455
- **Authorized official:** RAYDEL MIRANDA (PRESIDENT)
- **Authorized official phone:** (561) 410-5622

## Contact information

- **Practice address:** 1499 FOREST HILL BLVD, SUITE 106, LAKE CLARKE SHORES, FL 33406-6050
- **Practice address phone:** (561) 410-5622
- **Practice address fax:** (561) 410-5621
- **Mailing address:** 1499 FOREST HILL BLVD, SUITE 106, LAKE CLARKE SHORES, FL 33406-6050
- **Mailing address phone:** (561) 410-5622
- **Mailing address fax:** (561) 410-5621

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/20/2014
- **Last updated:** 02/20/2014