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General NPI Number Information
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NPI Number | 1679020747
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Entity Type | Organization
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Legal Business Name | JAETRIS HOMECARE SOLUTIONS, INC.
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 50 GLEN ST SUITE 310
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City | GLEN COVE
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State | NY
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Zip | 11542-4304
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Country | US
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Telephone | 516-430-5505
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Fax |
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Provider Business Mailing Address
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Address Line | 50 GLEN ST SUITE 310
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City | GLEN COVE
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State | NY
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Zip | 11542-4304
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Country | US
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Telephone | 516-430-5505
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LOVINA RIVERA
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Credential | BA, HHA
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Telephone | 516-351-0846
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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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