Healthcare Provider Details

I. General information

NPI: 1861606485
Provider Name (Legal Business Name): COMMUNITY HEALTH AND HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 11/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 CECIL A MALONE DR
ITHACA NY
14850-5124
US

IV. Provider business mailing address

138 CECIL A. MALONE DRIVE
ITHACA NY
14850-5124
US

V. Phone/Fax

Practice location:
  • Phone: 607-273-7780
  • Fax: 607-277-1494
Mailing address:
  • Phone: 607-273-7780
  • Fax: 607-277-1494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number9252L001
License Number StateNY

VIII. Authorized Official

Name: MS. SUE ELLEN STUART
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 607-273-0466