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General NPI Number Information
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NPI Number | 1447798194
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Entity Type | Organization
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Legal Business Name | LIFE QUALITY HOMECARE AGENCY INC
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 3057 CONEY ISLAND AVENUE
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 718-504-8666
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Fax | 718-891-2640
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Provider Business Mailing Address
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Address Line | 3057 CONEY ISLAND AVENUE
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 718-504-8666
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Fax | 718-891-2640
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARIANNA LEVIN
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Credential | RN
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Telephone | 718-504-8666
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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 | 1995L001
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License Number State | NY
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