=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124433164
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PAMPER OUR PARENTS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/28/2014
-----------------------------------------------------
Last Update Date | 07/08/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21 CANDLE LN
-----------------------------------------------------
City | LEVITTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11756-2501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-513-0396
-----------------------------------------------------
Fax | 516-513-0396
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21 CANDLE LN
-----------------------------------------------------
City | LEVITTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11756-2501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-513-0396
-----------------------------------------------------
Fax | 516-513-0396
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MS. DOROTHY A LEONARD
-----------------------------------------------------
Credential | CNA
-----------------------------------------------------
Telephone | 516-513-0396
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 342711250708E
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------