MEDICARE: SOBOLA ENTERPRISE & HOME CARE SERVICES INC.

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	1029L001	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1029L001	OTHER	NY	NEW YORK STATE DEPARTMENT OF HEALTH

General Provider Information

NPI Number	:	1457580128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOBOLA ENTERPRISE & HOME CARE SERVICES INC.

Provider Business Mailing Address
First Line	:	495 FLATBUSH AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-3782
Country	:	US
Telephone Number	:	800-515-4640
Fax Number	:	347-246-9551

Provider Business Practice Location Address
First Line	:	495 FLATBUSH AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-3782
Country	:	US
Telephone Number	:	800-515-4640
Fax Number	:	347-246-9551

Authorized Official
Title or Position	:	DIRECTOR / OWNER
Name	:	MS. HELEN BOSEDE JAMES
Credential	:
Telephone Number	:	917-627-1320

Provider Enumeration Date	:	07/02/2009
Last Update Date	:	02/13/2024

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