Provider Demographics
NPI:1093586976
Name:CAROLINE HOME CARE SERVICES INC
Entity Type:Organization
Organization Name:CAROLINE HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MS
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:REUBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-269-8222
Mailing Address - Street 1:17108 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-5428
Mailing Address - Country:US
Mailing Address - Phone:718-269-8222
Mailing Address - Fax:
Practice Address - Street 1:171 08 JAMAICA AVE
Practice Address - Street 2:JAMAICA
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11432-1143
Practice Address - Country:US
Practice Address - Phone:718-269-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06057914Medicaid