MEDICARE: CITI HEALTH HOME CARE SERVICES, 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
1	251E00000X	Home Health Agency	1423L001	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578002697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITI HEALTH HOME CARE SERVICES, INC

Provider Business Mailing Address
First Line	:	3018 GLENWOOD RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2642
Country	:	US
Telephone Number	:	718-856-6800
Fax Number	:	718-856-6878

Provider Business Practice Location Address
First Line	:	3018 GLENWOOD RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2642
Country	:	US
Telephone Number	:	718-856-6800
Fax Number	:	718-856-6878

Authorized Official
Title or Position	:	PRES/CEO
Name	:	MR. FANELL ALERTE
Credential	:
Telephone Number	:	718-856-6800

Provider Enumeration Date	:	02/22/2017
Last Update Date	:	02/22/2017

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