Judah in Home Support Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

017020700 Issued in FL

Legal business name

JUDAH IN HOME SUPPORT CARE INC

Practice address

4812 S Federal Hwy # 1
Fort Pierce, FL 34982-7078

Phone

(772) 742-8145

Fax

(772) 742-8145

NPI assigned

Apr 18, 2017

Last updated

Apr 18, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Charmaine Gaynor Muir

Title

Manager Owner

Phone

(772) 203-4762

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1326572272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 S US HIGHWAY 1",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349827078",
            "telephone_number": "772-203-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 S FEDERAL HWY # 1",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349827078",
            "telephone_number": "772-742-8145",
            "fax_number": "772-742-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDAH IN HOME SUPPORT CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "MUIR",
        "authorized_official_first_name": "CHARMAINE",
        "authorized_official_middle_name": "GAYNOR",
        "authorized_official_title_or_position": "MANAGER OWNER",
        "authorized_official_telephone_number": "772-203-4762",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "017020700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017020700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018713800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alexandra C Kaiser, MS
• Dana Kajan, DO

• Home Health Agency in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.