Provider Demographics
NPI:1053958041
Name:JABEZ HOME CARE LLC
Entity type:Organization
Organization Name:JABEZ HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-244-5808
Mailing Address - Street 1:2101 SW 101ST AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5090
Mailing Address - Country:US
Mailing Address - Phone:754-244-5808
Mailing Address - Fax:305-676-9040
Practice Address - Street 1:9045 LA FONTANA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-5642
Practice Address - Country:US
Practice Address - Phone:754-244-5808
Practice Address - Fax:305-676-9040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100246100Medicaid