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General NPI Number Information
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NPI Number | 1861905762
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Entity Type | Organization
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Legal Business Name | NEXT LEVEL PROFESSSIONAL SERVICES
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Dates
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Enumeration Date | 11/14/2017
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Last Update Date | 11/14/2017
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Provider Practice Location Address
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Address Line | 70 E SUNRISE HWY STE 500
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City | VALLEY STREAM
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State | NY
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Zip | 11581-1233
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Country | US
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Telephone | 770-203-5095
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Fax |
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Provider Business Mailing Address
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Address Line | 2216 NEW HAVEN AVE APT 7N
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-2562
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Country | US
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Telephone | 770-203-5095
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. LAJUANA PATRICE JAMES-JACKSON
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Credential | LPN
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Telephone | 770-203-5095
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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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