Healthcare Provider Details

I. General information

NPI: 1669175444
Provider Name (Legal Business Name): GLOBE HEALTH LCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 03/22/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 VAN BUREN ST
MASTIC NY
11950-4101
US

IV. Provider business mailing address

123 VAN BUREN ST
MASTIC NY
11950-4101
US

V. Phone/Fax

Practice location:
  • Phone: 631-839-8699
  • Fax:
Mailing address:
  • Phone: 631-839-8699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ROBERT J. GARCIA
Title or Position: PRESIDENT/CEO
Credential: LPN
Phone: 631-839-8699