Healthcare Provider Details

I. General information

NPI: 1700944998
Provider Name (Legal Business Name): PEOPLE HOME HEALTH CARE SERVICES CERTIFIED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 01/27/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

692 MILLERSPORT HWY
BUFFALO NY
14226-2401
US

IV. Provider business mailing address

1219 N FOREST RD
WILLIAMSVILLE NY
14221-3230
US

V. Phone/Fax

Practice location:
  • Phone: 716-874-5600
  • Fax: 716-566-4988
Mailing address:
  • Phone: 716-634-8132
  • Fax: 716-817-2509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1451602
License Number StateNY

VIII. Authorized Official

Name: JACOB TROY WILKINS
Title or Position: ADMINISTRATOR/VICE PRESIDENT
Credential: RN
Phone: 716-874-5600