Healthcare Provider Details

I. General information

NPI: 1669868865
Provider Name (Legal Business Name): CHRISTIAN CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 04/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19605 111TH AVE
SAINT ALBANS NY
11412-1713
US

IV. Provider business mailing address

19605 111TH AVE
SAINT ALBANS NY
11412-1713
US

V. Phone/Fax

Practice location:
  • Phone: 347-948-4806
  • Fax:
Mailing address:
  • Phone: 347-948-4806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: RODRIGUEZ POSY
Title or Position: CEO
Credential:
Phone: 347-948-4806