Healthcare Provider Details

I. General information

NPI: 1891135935
Provider Name (Legal Business Name): LOUIS CAREER DEVELOPMENT CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2013
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41-61 KISSENA BLVD. SUITE C29
FLUSHING NY
11355
US

IV. Provider business mailing address

41-61 KISSENA BLVD. SUITE C29
FLUSHING NY
11355
US

V. Phone/Fax

Practice location:
  • Phone: 718-461-0658
  • Fax: 718-461-0658
Mailing address:
  • Phone: 718-461-0658
  • Fax: 718-461-5562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1962L001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number1962L001
License Number StateNY

VIII. Authorized Official

Name: WENHUAN LU
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-461-0658