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General NPI Number Information
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NPI Number | 1639846892
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Entity Type | Organization
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Legal Business Name | CARLENE&RANDAL HOME AND COMAPNION CARE LLC
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 9712 REMINGTON ST
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City | JAMAICA
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State | NY
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Zip | 11435-4641
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Country | US
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Telephone | 646-659-2237
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Fax |
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Provider Business Mailing Address
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Address Line | 9712 REMINGTON ST
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City | JAMAICA
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State | NY
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Zip | 11435-4641
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Country | US
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Telephone | 646-659-2237
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARLENE ALICIA ANDERSON
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Credential | CERTIFIED NURSNG ASS
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Telephone | 646-659-2237
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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 |
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License Number State |
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