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General NPI Number Information
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NPI Number | 1154407492
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Entity Type | Organization
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Legal Business Name | SUNNYSIDE CITYWIDE HOME CARE SERVICES, INC.
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Dates
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Enumeration Date | 10/30/2006
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 43-31 39TH STREET
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City | SUNNYSIDE
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State | NY
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Zip | 11104
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Country | US
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Telephone | 718-784-6160
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Fax | 718-786-0823
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Provider Business Mailing Address
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Address Line | 43-31 39TH STREET
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City | SUNNYSIDE
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State | NY
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Zip | 11104
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Country | US
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Telephone | 718-784-6160
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Fax | 718-786-0823
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Authorized Official
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Title or Position | ASSOCIATE EXECUTIVE DIRECTOR
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Name | MRS. ANDREA THOMAS
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Credential |
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Telephone | 718-784-6160
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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 | 0911L001
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License Number State | NY
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