Healthcare Provider Details

I. General information

NPI: 1982912093
Provider Name (Legal Business Name): RICHMOND HOME NEED SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2010
Last Update Date: 09/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 AMBOY RD
STATEN ISLAND NY
10306-2799
US

IV. Provider business mailing address

3155 AMBOY RD
STATEN ISLAND NY
10306-2799
US

V. Phone/Fax

Practice location:
  • Phone: 718-313-1406
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number0076L001
License Number StateNY

VIII. Authorized Official

Name: MS. MARYELLEN WILLIAMSON
Title or Position: CFO
Credential:
Phone: 718-313-1406