Healthcare Provider Details

I. General information

NPI: 1972914828
Provider Name (Legal Business Name): PARACLETE HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 10/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 GERARD ST SUITE 100B
HUNTINGTON NY
11743-7060
US

IV. Provider business mailing address

50 GERARD STREET SUITE 100B
HUNTINGTON NY
11743-6927
US

V. Phone/Fax

Practice location:
  • Phone: 631-523-2344
  • Fax:
Mailing address:
  • Phone: 631-523-2344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2002L001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number2002L001
License Number StateNY

VIII. Authorized Official

Name: MARIE R. LOCHARD
Title or Position: DIRECTOR
Credential: CRNA
Phone: 631-523-2344