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General NPI Number Information
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NPI Number | 1104055888
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Entity Type | Organization
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Legal Business Name | HOME SWEET HOMECARE OF LI INC
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4747 NESCONSET HWY UNIT 28
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City | PORT JEFFERSON STA
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State | NY
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Zip | 11776
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Country | US
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Telephone | 631-828-8874
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Fax | 631-473-0870
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Provider Business Mailing Address
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Address Line | 4747 NESCONSET HWY UNIT 28
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City | PORT JEFFERSON ST
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State | NY
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Zip | 11776
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Country | US
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Telephone | 631-828-8874
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Fax | 631-473-0870
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CATHERINE JONES
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Credential |
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Telephone | 631-828-8874
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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 | 1551L-001
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License Number State | NY
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