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General NPI Number Information
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NPI Number | 1154635977
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Entity Type | Organization
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Legal Business Name | ADJ WISDOM HOME CARE INC
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 230 GRAND ST # 2MFL 2MFL
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City | NEW YORK
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State | NY
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Zip | 10013-4241
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Country | US
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Telephone | 212-226-8218
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Fax |
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Provider Business Mailing Address
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Address Line | 230 GRAND ST # 2MFL 2MFL
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City | NEW YORK
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State | NY
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Zip | 10013-4241
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Country | US
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Telephone | 212-226-8218
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. XIU MEI WENG
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Credential |
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Telephone | 212-226-8218
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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 | 1916L001
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License Number State | NY
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