Provider Demographics
NPI:1083884159
Name:LIBERTY HOME CARE NURSES EMPLOYMENT AGENCY, INC.
Entity Type:Organization
Organization Name:LIBERTY HOME CARE NURSES EMPLOYMENT AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-322-7519
Mailing Address - Street 1:10344 121ST ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2104
Mailing Address - Country:US
Mailing Address - Phone:718-322-7519
Mailing Address - Fax:718-322-8054
Practice Address - Street 1:10344 121ST ST
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-2104
Practice Address - Country:US
Practice Address - Phone:718-322-7519
Practice Address - Fax:718-322-8054
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIBERTY HOME CARE NURSES EMPLOYMENT AGENCY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-05
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY90811001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health