Healthcare Provider Details
I. General information
NPI: 1235615170
Provider Name (Legal Business Name): SENIORCARE COMPANIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/13/2018
Last Update Date: 07/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
152 ISLIP AVE SUITE 25
ISLIP NY
11751
US
IV. Provider business mailing address
152 ISLIP AVE SUITE 25
ISLIP NY
11751
US
V. Phone/Fax
- Phone: 631-581-9000
- Fax: 631-277-4311
- Phone: 631-581-9000
- Fax: 631-277-4311
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | 95044618000117 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
BERNHARD
JOHN
SENGSTOCK
Title or Position: PRESIDENT
Credential: DC
Phone: 631-581-9000