=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497977854
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME HEALTH SERVICES OF WESTCHESTER JEWISH COMMUNITY SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/03/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 845 N BROADWAY
-----------------------------------------------------
City | WHITE PLAINS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10603-2403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-761-0600
-----------------------------------------------------
Fax | 914-949-7488
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 845 N BROADWAY
-----------------------------------------------------
City | WHITE PLAINS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10603-2403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-761-0600
-----------------------------------------------------
Fax | 914-949-7488
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ASSISTANT EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MS. SHEILA RABIDEAU
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 914-761-0600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 0249L001
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------