Provider Demographics
NPI:1003819806
Name:AT HOME CARE INCORPORATED
Entity Type:Organization
Organization Name:AT HOME CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOME CARE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-432-7924
Mailing Address - Street 1:1 FOXCARE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2681
Mailing Address - Country:US
Mailing Address - Phone:607-432-7924
Mailing Address - Fax:607-432-7927
Practice Address - Street 1:1 FOXCARE DR STE 102
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2681
Practice Address - Country:US
Practice Address - Phone:607-432-7924
Practice Address - Fax:607-432-7927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3824601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01051096Medicaid
NY01051096Medicaid