Organization Active NPI

Tri-County Homecare of Florida, Inc.

  • Home Health Agency
  • Hollywood, FL
National Provider Identifier
1649205287
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
TRI-COUNTY HOMECARE OF FLORIDA, INC.
Practice address
2514 Hollywood Blvd
Suite 203
Hollywood, FL 33020
Phone
(954) 923-0695
Fax
(954) 926-7429
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Authorized official

Name
Yolande Stephenson
Title
Administrator
Phone
(954) 923-0695

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

2514 Hollywood Blvd
Suite 203
Hollywood, FL 33020

Mailing address

2514 Hollywood Blvd Ste 203
Hollywood, FL 33020-6637
Phone (954) 923-0695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060822000014 FL Part A Provider - Home Health Agency 3072516657 Practice locations: Hollywood, FL
O20200529001525 FL Part A Provider - Home Health Agency 3072516657 Practice locations: Boca Raton, FL

Home health agency certification: CCN 108445

Legal name
TRI-COUNTY HOMECARE OF FLORIDA, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 9, 2007
Last certification
Jun 7, 2013
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 17, 2005 in FL
Enrollment address
2514 Hollywood Blvd
203
Hollywood, FL 33020-6637

Home health agency certification: CCN 687058

Legal name
TRI-COUNTY HOMECARE OF FLORIDA, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 24, 2020
Last certification
Sep 24, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 13, 2005 in FL
Enrollment address
1 W Camino Real
Ste 205
Boca Raton, FL 33432-5940

Care Compare: Home health agency

Medicare Care Compare
Listed as
Tri-County Homecare of Florida, Inc.CCN 108445
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Aug 9, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Occupational therapy

Care Compare: Home health agency

Medicare Care Compare
Listed as
Tri-County Homecare of Florida, IncCCN 687058
Ownership
Proprietary
Certified
Sep 24, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1057623Tri County Homecare of Florida Inc2514 Hollywood Blvd Ste 203, Hollywood, FL 33020Certificate of waiverAug 16, 2026

National Provider Directory

National Provider Directory
Tax ID family
Tri-County Homecare of Florida2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1200 N Federal Hwy
Ofc 57
Boca Raton, FL 33432
Phone (561) 922-9178

1 W Camino Real
Ste 205
Boca Raton, FL 33432
Phone (561) 801-2448

2514 Hollywood Blvd
Ste 203
Hollywood, FL 33020
Phone (954) 923-0695

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly E Dent Individual W-2 Managing EmployeeAlternate Administrator Jan 1, 2022 80%
Corporate OfficerAlt Admin Oct 17, 2019
Corporate DirectorAlt Admin Oct 17, 2019
W-2 Managing EmployeeAlt Admin Oct 17, 2019
Operational/Managerial ControlAlt Admin Oct 17, 2019
Yolande I Stephenson Individual 5% Or Greater Direct Ownership Interest Aug 8, 2006
Corporate Director Aug 8, 2006
5% Or Greater Direct Ownership Interest Oct 28, 2019
Corporate OfficerPresident, Admin Jun 17, 2005 100%
Corporate DirectorPresident/Admin Jun 17, 2005 100%
W-2 Managing EmployeePresident/Admin Oct 17, 2005 100%
Operational/Managerial ControlPresident/Admin Jun 17, 2005 100%
Marie Dejean Individual W-2 Managing EmployeeDirector of Nursing Oct 29, 2019
Corporate OfficerDirector of Nursing Oct 17, 2019
Corporate DirectorDirector of Nursing Oct 17, 2019
W-2 Managing EmployeeDirector of Nursing Oct 17, 2019
Operational/Managerial ControlDirector of Nursing Oct 17, 2019

Practitioners & affiliated clinicians

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529280000000",
    "number": "1649205287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 HOLLYWOOD BLVD STE 203",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206637",
            "telephone_number": "954-923-0695",
            "fax_number": "954-926-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 HOLLYWOOD BLVD",
            "address_2": "SUITE 203",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33020",
            "telephone_number": "954-923-0695",
            "fax_number": "954-926-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY HOMECARE OF FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2018-06-18",
        "status": "A",
        "authorized_official_last_name": "STEPHENSON",
        "authorized_official_first_name": "YOLANDE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-923-0695"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.