=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669912432
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MORAL HOME CARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2017
-----------------------------------------------------
Last Update Date | 02/27/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 86 MICKENS BND
-----------------------------------------------------
City | W HENRIETTA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14586-9560
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-766-7642
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 86 MICKENS BND
-----------------------------------------------------
City | W HENRIETTA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14586-9560
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROPRIETOR
-----------------------------------------------------
Name | RAM L MAINALI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 585-281-8106
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------