Malibu Companion Services, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MALIBU COMPANION SERVICES, LLC

Practice address

7407 Cocoanut Dr
Lake Worth, FL 33467-6421

Phone

(770) 873-6303

Fax

(678) 625-2662

NPI assigned

Feb 2, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marthe Pierre

Title

RN

Phone

(770) 873-6303

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517529600000",
    "number": "1235638412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8106 WOODLAND CT SE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300143958",
            "telephone_number": "770-873-6303",
            "fax_number": "678-625-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7407 COCOANUT DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676421",
            "telephone_number": "770-873-6303",
            "fax_number": "678-625-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALIBU COMPANION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A",
        "authorized_official_last_name": "PIERRE",
        "authorized_official_first_name": "MARTHE",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "770-873-6303"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENT",
            "identifier": "1234",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1234",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330382076A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.