Healthcare Provider Details

I. General information

NPI: 1255970984
Provider Name (Legal Business Name): HCODE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2019
Last Update Date: 12/28/2019
Certification Date: 12/28/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212-29 HILLSIDE AVENUE 6EW
QUEENS VILLAGE NY
11427
US

IV. Provider business mailing address

212-29 HILLSIDE AVENUE 6EW
QUEENS VILLAGE NY
11427
US

V. Phone/Fax

Practice location:
  • Phone: 646-988-2752
  • Fax:
Mailing address:
  • Phone: 646-988-2752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ELIZABETH MWANGAGUHUNGA
Title or Position: CEO
Credential:
Phone: 646-988-2752