MEDICARE: ARLETTE'S HOME CARE AGENCY

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	314000000X	Skilled Nursing Facility	649845-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NY 20653	OTHER		AMERICAN HEALTH ASSOCIATE

General Provider Information

NPI Number	:	1770985038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLETTE'S HOME CARE AGENCY

Provider Business Mailing Address
First Line	:	8719 204TH ST APT A11
Second Line	:
City	:	HOLLIS
State	:	NY
Zip	:	11423-1527
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 FULTON AVE
Second Line	:	208
City	:	HEMPSTEAD
State	:	NY
Zip	:	11550-3917
Country	:	US
Telephone Number	:	516-505-4922
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ARLETTE STEWART
Credential	:
Telephone Number	:	347-301-3819

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/18/2014

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