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General NPI Number Information
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NPI Number | 1700078326
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Entity Type | Organization
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Legal Business Name | KDL HOME HEALTH CARE AGENCY, INC.
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 30 GALLEY HILL RD
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City | CUDDEBACKVILLE
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State | NY
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Zip | 12729-5204
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Country | US
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Telephone | 845-754-8756
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Fax | 845-754-7141
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Provider Business Mailing Address
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Address Line | 30 GALLEY HILL RD
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City | CUDDEBACKVILLE
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State | NY
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Zip | 12729-5204
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Country | US
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Telephone | 845-754-8756
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Fax | 845-754-7141
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. PATRICIA A. LICHT
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Credential |
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Telephone | 845-754-8756
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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 | 9806L001
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 9806L001
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License Number State | NY
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