Provider Demographics
NPI:1013202902
Name:HOME CARE
Entity Type:Organization
Organization Name:HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-685-0604
Mailing Address - Street 1:9 ZECK CT
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3425
Mailing Address - Country:US
Mailing Address - Phone:917-685-0604
Mailing Address - Fax:
Practice Address - Street 1:9 ZECK CT
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-3425
Practice Address - Country:US
Practice Address - Phone:917-685-0604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-19
Last Update Date:2011-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY640959-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health