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General NPI Number Information
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NPI Number | 1740503283
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Entity Type | Organization
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Legal Business Name | SWEET HOME CARE
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Dates
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Enumeration Date | 03/11/2010
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 255-43 147RH RD
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City | ROSEDALE
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State | NY
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Zip | 11422
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Country | US
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Telephone | 718-949-5894
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Fax |
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Provider Business Mailing Address
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Address Line | 25543 147TH RD
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City | ROSEDALE
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State | NY
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Zip | 11422-2827
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MRS. MARIE C ETIENNE
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Credential |
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Telephone | 718-949-5994
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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 | 266637-1
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License Number State | NY
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