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General NPI Number Information
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NPI Number | 1083884159
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Entity Type | Organization
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Legal Business Name | LIBERTY HOME CARE NURSES EMPLOYMENT AGENCY, INC.
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 10344 121ST ST
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-2104
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Country | US
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Telephone | 718-322-7519
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Fax | 718-322-8054
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Provider Business Mailing Address
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Address Line | 10344 121ST ST SECOND FLOOR
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-2104
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Country | US
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Telephone | 718-322-7519
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Fax | 718-322-8054
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CHRISTINE PERSAUD
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Credential |
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Telephone | 718-322-7519
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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 | 90811001
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License Number State | NY
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