Healthcare Provider Details

I. General information

NPI: 1295951614
Provider Name (Legal Business Name): CITI HEALTH HOME CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3018 GLENWOOD ROAD
BROOKLYN NY
11210
US

IV. Provider business mailing address

3018 GLENWOOD ROAD
BROOKLYN NY
11210
US

V. Phone/Fax

Practice location:
  • Phone: 718-856-6800
  • Fax: 718-856-6878
Mailing address:
  • Phone: 718-856-6800
  • Fax: 718-856-6878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: FANELL ALERTE
Title or Position: PRES/CEO
Credential:
Phone: 718-856-6800