Provider Demographics
NPI:1871993022
Name:SENIOR HOME CARE AGENCY, LLC
Entity type:Organization
Organization Name:SENIOR HOME CARE AGENCY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:ANNMARIE
Authorized Official - Last Name:HYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-244-9744
Mailing Address - Street 1:3601 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1375
Mailing Address - Country:US
Mailing Address - Phone:646-545-1235
Mailing Address - Fax:516-520-0400
Practice Address - Street 1:3601 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 203
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1375
Practice Address - Country:US
Practice Address - Phone:646-545-1235
Practice Address - Fax:516-520-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health