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General NPI Number Information
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NPI Number | 1083088769
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Entity Type | Organization
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Legal Business Name | PRINCIPLE HOMECARE
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 134 PONINGO ST
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City | PORT CHESTER
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State | NY
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Zip | 10573-4010
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Country | US
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Telephone | 914-912-0710
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Fax |
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Provider Business Mailing Address
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Address Line | 134 PONINGO ST
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City | PORT CHESTER
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State | NY
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Zip | 10573-4010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | SASHA B GUILLAUME
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Credential |
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Telephone | 914-912-0710
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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 | 1524L001
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1524L002
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License Number State | NY
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