Provider Demographics
NPI:1033275292
Name:TELFORD HOME ASSISTANCE INC
Entity Type:Organization
Organization Name:TELFORD HOME ASSISTANCE INC
Other - Org Name:EXTENDED CARE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TAGLICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-234-2000
Mailing Address - Street 1:1 RABRO DRIVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-4270
Mailing Address - Country:US
Mailing Address - Phone:631-234-2000
Mailing Address - Fax:631-234-2589
Practice Address - Street 1:1 RABRO DRIVE
Practice Address - Street 2:SUITE 104
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4270
Practice Address - Country:US
Practice Address - Phone:631-234-2000
Practice Address - Fax:631-234-2589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0044L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00914585Medicaid
NY00946314Medicaid