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General NPI Number Information
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NPI Number | 1740757251
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Entity Type | Organization
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Legal Business Name | INCLUSIVE HEALTH, LLC
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Dates
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Enumeration Date | 11/01/2018
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Last Update Date | 12/07/2018
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Provider Practice Location Address
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Address Line | 72 VAN NAME AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10303-2514
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Country | US
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Telephone | 347-322-8015
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Fax |
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Provider Business Mailing Address
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Address Line | 72 VAN NAME AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10303-2514
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Country | US
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Telephone | 347-322-8015
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PRISCILLA ROSE SANTANA
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Credential | NURSE PRACTITIONER
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Telephone | 347-322-8015
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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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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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