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General NPI Number Information
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NPI Number | 1366804841
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Entity Type | Organization
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Legal Business Name | SIMPLE CARE IN YOUR HOME
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 90 KRON ST
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City | ROCHESTER
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State | NY
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Zip | 14619-2036
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Country | US
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Telephone | 585-397-2675
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Fax |
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Provider Business Mailing Address
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Address Line | 83 COLUMBIA AVE
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City | ROCHESTER
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State | NY
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Zip | 14608-2647
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. BREANNA STEWART
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Credential |
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Telephone | 585-397-2675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 343224800212E
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License Number State | NY
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