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General NPI Number Information
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NPI Number | 1427467950
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Entity Type | Organization
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Legal Business Name | OMEGA CARE & HEALTH,INC.
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 4 RICHARD DR
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City | MEDFORD
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State | NY
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Zip | 11763-1696
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Country | US
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Telephone | 631-207-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 212 MEDFORD AVE
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City | PATCHOGUE
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State | NY
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Zip | 11772-1210
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Country | US
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Telephone | 631-207-2626
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LILETHE ACEVEDO
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Credential | LPN
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Telephone | 631-207-2626
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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 | 1943L001
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License Number State | NY
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