Organization
MODIVCARE SOLUTIONS, LLC
Active
Parent organization
MODIVCARE INC.
Other names
LGTC FL AHCA
Organization subpart
Yes
Provider details
NPI number
Legal business name
MODIVCARE INC.
Authorized official
DANIEL GREENLEAF (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(800) 486-7647
Entity
Organization
Contact information
Practice address
5875 NW 163RD ST STE 203, MIAMI LAKES, FL 33014-5618
(800) 698-8457
(305) 471-0443
Mailing address
1275 PEACHTREE ST NE, 6TH FLOOR, ATLANTA, GA 30309-3580
(800) 486-7647
(404) 888-5999
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014158200
—
FL
05
—
014158201
—
FL
05
—
014158202
—
FL
05
—
014158203
—
FL
05
—
014158204
—
FL
Enumeration date
04/22/2015
Last updated
01/27/2021
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