Provider Demographics
NPI:1174678833
Name:HUMANLY HOME HEALTH CARE AGENCY, INC.
Entity type:Organization
Organization Name:HUMANLY HOME HEALTH CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-221-4488
Mailing Address - Street 1:11890 SW 8TH ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1743
Mailing Address - Country:US
Mailing Address - Phone:305-221-4488
Mailing Address - Fax:305-221-7995
Practice Address - Street 1:11890 SW 8TH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1743
Practice Address - Country:US
Practice Address - Phone:305-221-4488
Practice Address - Fax:305-221-7995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992593251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651522300Medicaid
FL109073Medicare Oscar/Certification