Healthcare Provider Details

I. General information

NPI: 1851440374
Provider Name (Legal Business Name): LITSON HEALTH CARE., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 E MAIN ST SUITE 501
MIDDLETOWN NY
10940-2653
US

IV. Provider business mailing address

346 DELAWARE AVE
BUFFALO NY
14202-1804
US

V. Phone/Fax

Practice location:
  • Phone: 845-342-1661
  • Fax: 845-342-2629
Mailing address:
  • Phone: 716-856-7500
  • Fax: 716-856-7506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0790L001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number0790L001
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number0790L001
License Number StateNY

VIII. Authorized Official

Name: MR. PATRICK TODD LYLES
Title or Position: SR. VP ADMINISTRATION
Credential:
Phone: 502-891-1044