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General NPI Number Information
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NPI Number | 1235355835
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Entity Type | Organization
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Legal Business Name | ROCKAWAY HOME ATTENDANT SERVICES, INC.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 10/23/2015
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Provider Practice Location Address
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Address Line | 1603 CENTRAL AVE SUITE 100
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-4003
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Country | US
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Telephone | 718-471-5800
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Fax | 718-327-0001
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Provider Business Mailing Address
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Address Line | 1603 CENTRAL AVE SUITE 100
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-4003
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Country | US
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Telephone | 718-471-5800
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Fax | 718-327-0001
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATION
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Name | MR. ENOSA S AIBANGBEE
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Credential |
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Telephone | 718-471-5800
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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 | 251E0000X
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License Number State | NY
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