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General NPI Number Information
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NPI Number | 1093998072
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Entity Type | Organization
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Legal Business Name | GOODCARE HOME HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 1330 NIAGARA FALLS BLVD SUITE 202
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City | TONAWANDA
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State | NY
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Zip | 14150-8900
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Country | US
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Telephone | 716-833-3445
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Fax | 716-407-0625
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Provider Business Mailing Address
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Address Line | 1330 NIAGARA FALLS BLVD SUITE 202
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City | TONAWANDA
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State | NY
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Zip | 14150-8900
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Country | US
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Telephone | 716-833-3445
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Fax | 716-407-0625
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. VALERY P SANDYREV
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Credential |
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Telephone | 716-833-3445
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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 | 1068L001
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License Number State | NY
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