=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144528159
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANGELCARE HOME CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/01/2011
-----------------------------------------------------
Last Update Date | 03/01/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 261 W CHESTER ST
-----------------------------------------------------
City | LONG BEACH
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11561-1914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-582-5624
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 261 W CHESTER ST 261 W. CHESTER ST.
-----------------------------------------------------
City | LONG BEACH
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11561-1914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-582-5624
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. ADINAH RUBIN
-----------------------------------------------------
Credential | RN, CWS
-----------------------------------------------------
Telephone | 516-582-5624
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------