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General NPI Number Information
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NPI Number | 1215433107
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Entity Type | Organization
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Legal Business Name | MANACH LLC
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Dates
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Enumeration Date | 04/01/2018
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Last Update Date | 11/15/2020
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Provider Practice Location Address
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Address Line | 45 LUDLOW ST STE 312
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City | YONKERS
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State | NY
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Zip | 10705-1949
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Country | US
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Telephone | 914-843-3217
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Fax | 914-470-0116
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Provider Business Mailing Address
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Address Line | 45 LUDLOW ST STE 312
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City | YONKERS
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State | NY
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Zip | 10705-1949
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Country | US
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Telephone | 914-843-3217
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Fax | 914-470-0116
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CHURCHILL EGONE
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Credential | MS ED
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Telephone | 914-843-3217
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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 | 2417L001
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License Number State | NY
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