MEDICARE: COMMUNITY HOME CARE REFERRAL SERVICE, 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	0484L001	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487721155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HOME CARE REFERRAL SERVICE, INC.

Provider Business Mailing Address
First Line	:	4107 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1332
Country	:	US
Telephone Number	:	718-435-8191
Fax Number	:	718-972-3854

Provider Business Practice Location Address
First Line	:	4107 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1332
Country	:	US
Telephone Number	:	718-435-8191
Fax Number	:	718-972-3854

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. BARRY WEISS
Credential	:
Telephone Number	:	718-435-8191

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	08/22/2020

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