Provider Demographics
NPI:1245904143
Name:ZYCOM CLIENT SUPPORT
Entity type:Organization
Organization Name:ZYCOM CLIENT SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHEVAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:OMEALLY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-695-7720
Mailing Address - Street 1:7869 FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-1238
Mailing Address - Country:US
Mailing Address - Phone:954-695-7720
Mailing Address - Fax:
Practice Address - Street 1:7869 FOREST BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-1238
Practice Address - Country:US
Practice Address - Phone:954-695-7720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care