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General NPI Number Information
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NPI Number | 1184141608
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Entity Type | Organization
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Legal Business Name | MITU HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3747 73RD ST
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6277
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Country | US
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Telephone | 718-255-1161
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Fax | 718-255-1025
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Provider Business Mailing Address
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Address Line | 3747 73RD ST
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6277
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Country | US
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Telephone | 718-255-1161
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Fax | 718-255-1025
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Authorized Official
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Title or Position | OWNER
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Name | BONIJ RONJAN
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Credential |
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Telephone | 646-730-8416
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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 |
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License Number State |
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Taxonomy #2
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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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