Healthcare Provider Details

I. General information

NPI: 1871032722
Provider Name (Legal Business Name): CHRISTINE HOME CARE SERVICES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12013 LIBERTY AVE
SOUTH RICHMOND HILL NY
11419-2117
US

IV. Provider business mailing address

120-13 LIBERTY AVE
RICHMOND HILL NY
11419
US

V. Phone/Fax

Practice location:
  • Phone: 718-843-8449
  • Fax: 718-843-8436
Mailing address:
  • Phone: 718-843-8449
  • Fax: 718-843-8436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1878L001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number1878L001
License Number StateNY

VIII. Authorized Official

Name: CHRISTINE PERSAUD
Title or Position: PRESIDENT
Credential: CHRISTINE PERSAUD
Phone: 917-592-8686