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General NPI Number Information
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NPI Number | 1003961426
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Entity Type | Organization
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Legal Business Name | COTTAGE HOMECARE, SERVICES, INC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 25 NEWBRIDGE RD STE 302
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City | HICKSVILLE
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State | NY
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Zip | 11801-2887
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Country | US
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Telephone | 516-367-2266
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Fax | 516-367-1067
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Provider Business Mailing Address
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Address Line | 25 NEWBRIDGE RD STE 302
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City | HICKSVILLE
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State | NY
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Zip | 11801-2887
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Country | US
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Telephone | 516-367-2266
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Fax | 516-367-1067
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KENNETH VILLANI
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Credential | RPH
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Telephone | 516-367-2266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 9239L001
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License Number State | NY
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