Organization
NANA'S HOME CARE, INC.
Active
Other names
Nana's Home Care, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MACDALIE AUMOITHE CNA (ADMINISTRATOR)
(561) 666-0049
Entity
Organization
Contact information
Practice address
2090 SE RAINIER RD, PORT SAINT LUCIE, FL 34952-7612
(561) 666-0049
Mailing address
2090 SE RAINIER RD, PORT SAINT LUCIE, FL 34952-7612
(561) 666-0049
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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