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General NPI Number Information
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NPI Number | 1134871353
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Entity Type | Organization
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Legal Business Name | LONGLIFE HOME CARE LLC
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 100 NIANTIC AVE STE B
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City | PROVIDENCE
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State | RI
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Zip | 02907-3146
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Country | US
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Telephone | 401-251-2166
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Fax | 401-240-4415
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Provider Business Mailing Address
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Address Line | 100 NIANTIC AVE STE B
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City | PROVIDENCE
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State | RI
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Zip | 02907-3146
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Country | US
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Telephone | 401-251-2166
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Fax | 401-240-4415
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | RASAQ A ALABEDE
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Credential |
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Telephone | 401-699-1196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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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 |
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License Number State |
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