Basic Information
Provider Information
NPI: 1245272038
EntityType: 2
ReplacementNPI:  
OrganizationName: ABLE PALMS HOME & HEALTH CARE SERVICES, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ABLE CARE CONNECT HOME HEALTH
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1107 HAZELTINE BLVD
Address2: SUITE 200
City: CHASKA
State: MN
PostalCode: 553181009
CountryCode: US
TelephoneNumber: 9523618000
FaxNumber: 9523618060
Practice Location
Address1: 300 LAKE AVE NE
Address2: SUITE 100
City: LARGO
State: FL
PostalCode: 337716605
CountryCode: US
TelephoneNumber: 7275862711
FaxNumber: 7275862565
Other Information
ProviderEnumerationDate: 06/13/2006
LastUpdateDate: 01/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WEICHERT
AuthorizedOfficialFirstName: JAMES
AuthorizedOfficialMiddleName: A
AuthorizedOfficialTitleorPosition: AUTHORIZED OFFICIAL
AuthorizedOfficialTelephone: 9523618000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000XHHA20073096FLY AgenciesHome Health 

No ID Information.


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