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General NPI Number Information
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NPI Number | 1417497785
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Entity Type | Organization
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Legal Business Name | PEREGRINE HOMECARE
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 1551 EAST GENESEE STREET SUITE 100
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City | SKANEATELES
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State | NY
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Zip | 13152-8879
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Country | US
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Telephone | 315-685-5170
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Fax | 315-685-5186
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Provider Business Mailing Address
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Address Line | 1551 EAST GENESEE STREET SUITE 100
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City | SKANEATELES
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State | NY
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Zip | 13152
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Country | US
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Telephone | 315-685-5170
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Fax | 315-685-5186
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CASSANDRA ANN KALET-CLARE
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Credential | R.N.
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Telephone | 315-685-5170
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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 | 1509L001
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License Number State | NY
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