MEDICARE: RICHMOND HOME NEED 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	251B00000X	Case Management Agency	0076L001	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	:	1689729782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMOND HOME NEED SERVICES, INC.

Provider Business Mailing Address
First Line	:	3155 AMBOY RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2799
Country	:	US
Telephone Number	:	718-313-1405
Fax Number	:	718-987-7449

Provider Business Practice Location Address
First Line	:	3155 AMBOY RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2799
Country	:	US
Telephone Number	:	718-313-1405
Fax Number	:	718-987-7449

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. EDWARD JOHN KLINGELE
Credential	:
Telephone Number	:	718-313-1405

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	08/22/2020

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