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General NPI Number Information
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NPI Number | 1588795355
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Entity Type | Organization
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Legal Business Name | LONG ISLAND CARE AT HOME LTD
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1400 OLD COUNTRY ROAD SUITE 108
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City | WESTBURY
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State | NY
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Zip | 11590-5119
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Country | US
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Telephone | 516-794-0700
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Fax | 516-794-0787
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Provider Business Mailing Address
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Address Line | 1400 OLD COUNTRY ROAD SUITE 108
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City | WESTBURY
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State | NY
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Zip | 11590-5119
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Country | US
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Telephone | 516-794-0700
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Fax | 516-794-0787
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Authorized Official
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Title or Position | V PRES
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Name | MARYANN C OSBORNE
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Credential |
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Telephone | 516-794-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 9376L001
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License Number State | NY
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