Provider Demographics
NPI:1205060472
Name:CONQUEST HOME CARE PLUS, INC.
Entity type:Organization
Organization Name:CONQUEST HOME CARE PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACINTH
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-486-8156
Mailing Address - Street 1:7501 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4982
Mailing Address - Country:US
Mailing Address - Phone:954-486-8156
Mailing Address - Fax:954-486-0791
Practice Address - Street 1:7501 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-4982
Practice Address - Country:US
Practice Address - Phone:954-486-8156
Practice Address - Fax:954-486-0791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health