Healthcare Provider Details

I. General information

NPI: 1821315292
Provider Name (Legal Business Name): CUDLEY'S HOME CARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 E 149TH ST RM 506
BRONX NY
10455-0860
US

IV. Provider business mailing address

391 E 149TH ST RM 506
BRONX NY
10455-0860
US

V. Phone/Fax

Practice location:
  • Phone: 718-401-2231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0629L001
License Number StateNY

VIII. Authorized Official

Name: JARITIE ANDERSON
Title or Position: CEO
Credential:
Phone: 718-401-2231