Provider Demographics
NPI:1861758732
Name:RECOVERY HOME CARE, INC.
Entity type:Organization
Organization Name:RECOVERY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:GINNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SKULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-200-2760
Mailing Address - Street 1:544 NW UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2283
Mailing Address - Country:US
Mailing Address - Phone:772-200-2760
Mailing Address - Fax:772-200-2760
Practice Address - Street 1:701 E COMMERCIAL BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3391
Practice Address - Country:US
Practice Address - Phone:954-351-8814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991378251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
107679OtherMEDICARE PTAN