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NPI Code Detail

MEDICARE: DOJ LONG TERM HOME HEALTH CARE PROGRAM, INC.

MEDICARE: DOJ LONG TERM HOME HEALTH CARE PROGRAM, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency7000342NNY

General Provider Information

NPI Number : 1518130681
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOJ LONG TERM HOME HEALTH CARE PROGRAM, INC.
Provider Business Mailing Address
First Line : 1160 TELLER AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-4145
Country : US
Telephone Number : 718-293-1500
Fax Number : 718-992-7074
Provider Business Practice Location Address
First Line : 1160 TELLER AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-4145
Country : US
Telephone Number : 718-293-1500
Fax Number : 718-992-7074
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. GILBERT MANUEL PREIRA
Credential :
Telephone Number : 718-293-1500
Provider Enumeration Date : 04/09/2008
Last Update Date : 04/09/2008

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