Healthcare Provider Details

I. General information

NPI: 1700061876
Provider Name (Legal Business Name): SHENE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 05/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MCGRATH STAND LN
SAG HARBOR NY
11963-2830
US

IV. Provider business mailing address

PO BOX 1994
EAST HAMPTON NY
11937-0908
US

V. Phone/Fax

Practice location:
  • Phone: 631-324-9555
  • Fax: 631-458-1426
Mailing address:
  • Phone: 631-324-9555
  • Fax: 631-458-1426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1127L001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number1127L001
License Number StateNY

VIII. Authorized Official

Name: MS. BETHANY SHENE
Title or Position: ADMINISTRATOR PRESIDENT
Credential: LPN
Phone: 631-324-9555