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General NPI Number Information
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NPI Number | 1437671997
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Entity Type | Organization
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Legal Business Name | PHOENIX HOME CARE SERCIVES, LLC
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Dates
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Enumeration Date | 07/16/2017
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Last Update Date | 07/16/2017
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Provider Practice Location Address
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Address Line | 11701 GUY R BREWER BLVD
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City | JAMAICA
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State | NY
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Zip | 11434-2148
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Country | US
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Telephone | 347-954-7010
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Fax |
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Provider Business Mailing Address
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Address Line | 2533 TIEMANN AVE
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City | BRONX
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State | NY
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Zip | 10469-6111
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Country | US
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Telephone | 347-954-7010
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Fax | 347-427-1494
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Authorized Official
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Title or Position | CEO
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Name | MS. CATHY LOVINSKY
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Credential | RN
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Telephone | 718-514-3328
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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 |
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License Number State | NY
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