Distinctive Home Care, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

30211309 Issued in FL

Legal business name

DISTINCTIVE HOME CARE, LLC

Practice address

6460 NW 5TH Way
Ft Lauderdale, FL 33309-6112

Phone

(954) 727-9142

Fax

(954) 727-2825

NPI assigned

Dec 21, 2007

Organization subpart

No

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

Authorized official

Name

Sharon Huggins

Title

Administrator

Phone

(954) 727-9142

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Distinctive Home Care Doing business as

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1861676157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33920 US HIGHWAY 19 N",
            "address_2": "SUITE 341",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346842654",
            "telephone_number": "727-786-5520",
            "fax_number": "727-787-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6460 NW 5TH WAY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333096112",
            "telephone_number": "954-727-9142",
            "fax_number": "954-727-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "HUGGINS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-727-9142"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "30211309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE DUTY/NURSE REGIST",
            "identifier": "30211309",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Distinctive Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.