MEDICARE: JEWISH HOME LIFECARE, COMMUNITY SERVICES

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

General Provider Information

NPI Number	:	1750628772
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEWISH HOME LIFECARE, COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	2900 EXTERIOR ST
Second Line	:	2
City	:	BRONX
State	:	NY
Zip	:	10463-7103
Country	:	US
Telephone Number	:	718-367-1125
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 EXTERIOR ST
Second Line	:	2
City	:	BRONX
State	:	NY
Zip	:	10463-7103
Country	:	US
Telephone Number	:	718-367-1125
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	AUDREY WEINER
Credential	:	DSW
Telephone Number	:	212-870-4600

Provider Enumeration Date	:	01/10/2013
Last Update Date	:	01/10/2013

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