Active NPI
Tri-County Homecare of Florida, Inc.
- Home Health Agency
- Hollywood, FL
On this page
- Key facts
- NPPES NPI Registry
- Medicare participation
- Care Compare: Home health agency
- Care Compare: Home health agency
- Laboratory certificates & supplier records
- National Provider Directory
- Ownership & related parties
- Practitioners & affiliated clinicians
- NPI Registry JSON
- Other providers in Hollywood, FL
- Sources for this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 FL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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
- Corporation
- 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.
- Overall star rating
- Ownership
- Proprietary
- Certified
- Aug 9, 2007
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Occupational therapy
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Tri-County Homecare of Florida, Inc
- Ownership
- Proprietary
- Certified
- Sep 24, 2020
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D1057623 | Tri County Homecare of Florida Inc | Certificate of waiver | Aug 16, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Tri-County Homecare of Florida
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Boca Raton, FL
- NPI 1285401729
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Kimberly E Dent | W-2 Managing Employee | Jan 1, 2022 | 80% |
| Corporate Officer | Oct 17, 2019 | ||
| Corporate Director | Oct 17, 2019 | ||
| W-2 Managing Employee | Oct 17, 2019 | ||
| Operational/Managerial Control | Oct 17, 2019 | ||
| Yolande I Stephenson | 5% Or Greater Direct Ownership Interest | Aug 8, 2006 | |
| Corporate Director | Aug 8, 2006 | ||
| 5% Or Greater Direct Ownership Interest | Oct 28, 2019 | ||
| Corporate Officer | Jun 17, 2005 | 100% | |
| Corporate Director | Jun 17, 2005 | 100% | |
| W-2 Managing Employee | Oct 17, 2005 | 100% | |
| Operational/Managerial Control | Jun 17, 2005 | 100% | |
| Marie Dejean | W-2 Managing Employee | Oct 29, 2019 | |
| Corporate Officer | Oct 17, 2019 | ||
| Corporate Director | Oct 17, 2019 | ||
| W-2 Managing Employee | Oct 17, 2019 | ||
| Operational/Managerial Control | Oct 17, 2019 |
Practitioners & affiliated clinicians
Affiliated clinicians 4
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Health Clinical Nurse Specialist
- Jupiter, FL
- NPI 1528462454
Home health agency
-
- Family Nurse Practitioner
- Boynton Beach, FL
- NPI 1326728585
Home health agency
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.