Provider Demographics
NPI:1003368861
Name:ANR HOMECARE SERVICES, LLC
Entity Type:Organization
Organization Name:ANR HOMECARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPS/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALECIA
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-285-9993
Mailing Address - Street 1:217-02 JAMAICA AVENUE 2ND FL
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428
Mailing Address - Country:US
Mailing Address - Phone:718-285-9993
Mailing Address - Fax:866-621-5989
Practice Address - Street 1:217-02 JAMAICA AVENUE 2ND FL
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428
Practice Address - Country:US
Practice Address - Phone:718-285-9993
Practice Address - Fax:866-621-5989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2400L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health