Provider Demographics
NPI:1487058400
Name:DEPENDABLE SENIOR CARE LLC
Entity type:Organization
Organization Name:DEPENDABLE SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:ROCHE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:561-699-0348
Mailing Address - Street 1:2000 PALM BEACH LAKES BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6504
Mailing Address - Country:US
Mailing Address - Phone:561-806-6525
Mailing Address - Fax:561-634-2797
Practice Address - Street 1:2000 PALM BEACH LAKES BLVD STE 202
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6504
Practice Address - Country:US
Practice Address - Phone:561-806-6525
Practice Address - Fax:561-634-2797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211730253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL119786400Medicaid