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General NPI Number Information
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NPI Number | 1659972024
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Entity Type | Organization
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Legal Business Name | CONSORTIUM HOME CARE INC
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 2397B HYLAN BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-3148
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Country | US
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Telephone | 718-928-3886
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Fax | 718-233-9693
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Provider Business Mailing Address
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Address Line | 2397B HYLAN BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-3148
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Country | US
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Telephone | 718-928-3886
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Fax | 718-233-9693
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Authorized Official
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Title or Position | DIRECTOR
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Name | YUN YUN LI
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Credential |
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Telephone | 929-461-4872
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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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