Organization
HEALTHE HOME DELIVERED MEALS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUZETTE M WENNER (PRESIDENT)
(954) 975-9611
Entity
Organization
Contact information
Practice address
6876 POWERLINE RD, FT LAUDERDALE, FL 33309-2156
(954) 975-9611
(954) 974-8073
Mailing address
3606 S OCEAN BLVD, #204, HIGHLAND BEACH, FL 33487-3351
(954) 975-9611
(954) 974-8073
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
NOS1616322
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080475400
MEDICAID WAIVER
FL
01
—
080475401
MEDICAID WAIVER
FL
Enumeration date
09/23/2010
Last updated
09/23/2010
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