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Organization

DETERMINED CARE HOME HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHACHLE ALTIDOR LPN (OWNER)
(954) 245-5129
Entity
Organization

Contact information

Practice address
648 NE 34TH CT, OAKLAND PARK, FL 33334-2850
(954) 245-5129
(954) 827-2349
Mailing address
648 NE 34TH CT, OAKLAND PARK, FL 33334-2850
(954) 245-5129
(954) 827-2349

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
PN5211091
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
82-34460552
IRS
FL
Enumeration date
11/27/2017
Last updated
11/27/2017
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