Provider Demographics
NPI:1538338298
Name:EL SHADAI HOME HEALTH CARE INC
Entity type:Organization
Organization Name:EL SHADAI HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-805-1373
Mailing Address - Street 1:8304 NW SOUTH RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7422
Mailing Address - Country:US
Mailing Address - Phone:305-805-1373
Mailing Address - Fax:305-805-1375
Practice Address - Street 1:8304 NW SOUTH RIVER DR
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33166-7422
Practice Address - Country:US
Practice Address - Phone:305-805-1373
Practice Address - Fax:305-805-1375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993029251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health