Provider Demographics
NPI:1942255237
Name:HOME HEALTH SPECIALISTS LLC
Entity type:Organization
Organization Name:HOME HEALTH SPECIALISTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-850-0042
Mailing Address - Street 1:2203 N LOIS AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-2387
Mailing Address - Country:US
Mailing Address - Phone:813-850-0042
Mailing Address - Fax:813-850-0043
Practice Address - Street 1:5039 TOWNSHIP LINE RD FL 2
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-4847
Practice Address - Country:US
Practice Address - Phone:610-566-2700
Practice Address - Fax:610-892-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA728205251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009941040003Medicaid
PA0009941040005Medicaid
PA0009941040007Medicaid
PA0099410401Medicaid
PA397282Medicare ID - Type UnspecifiedCAHABA
PA0009941040003Medicaid
PA1039852Medicaid
PA0099410401Medicaid