MEDICARE: ASSISTCARE HOME HEALTH SERVICES LLC CDPAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1265259840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSISTCARE HOME HEALTH SERVICES LLC CDPAS

Provider Business Mailing Address
First Line	:	2357 60TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-2689
Country	:	US
Telephone Number	:	718-841-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2357 60TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-2689
Country	:	US
Telephone Number	:	718-841-8000
Fax Number	:

Authorized Official
Title or Position	:	ADMIN
Name	:	IVELISSA CRUZ
Credential	:
Telephone Number	:	718-841-8000

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	10/14/2024

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