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General NPI Number Information
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NPI Number | 1497179527
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Entity Type | Organization
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Legal Business Name | ADVANCED LIFE CARE PLANNING LLC
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 02/10/2014
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Provider Practice Location Address
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Address Line | 255 KATAN AVE. SCORE REHAB
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City | STATEN ISLAND
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State | NY
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Zip | 10308
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Country | US
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Telephone | 646-688-5200
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Fax |
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Provider Business Mailing Address
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Address Line | BOX 20377 PARK WEST STATION
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City | NEW YORK
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State | NY
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Zip | 10025-1513
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Country | US
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Telephone | 917-543-2245
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Fax | 775-320-7171
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Authorized Official
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Title or Position | DIRECTOR
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Name | ARLETTE C LOESER
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Credential | OTR
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Telephone | 212-947-8222
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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 | 556613
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License Number State | NY
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