Organization
PRODIGY HOME HEALTH
Active
Other names
PRODIGY HOMEMAKERS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL AMUZU (ADMINISTRATOR)
(708) 267-0032
Entity
Organization
Contact information
Practice address
7601 COBB LN, PENSACOLA, FL 32534-4264
(850) 475-1859
Mailing address
16945 GLEN OAKS DR, COUNTRY CLUB HILLS, IL 60478-2149
(708) 267-0032
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690055196
—
FL
Enumeration date
04/20/2009
Last updated
04/21/2009
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