Provider Demographics
NPI:1104365782
Name:AGE AND CARE HOME CARE SERVICES INC.
Entity Type:Organization
Organization Name:AGE AND CARE HOME CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOFAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-399-7591
Mailing Address - Street 1:6485 WETHEROLE ST
Mailing Address - Street 2:APT 4D
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4067
Mailing Address - Country:US
Mailing Address - Phone:347-399-7591
Mailing Address - Fax:
Practice Address - Street 1:6485 WETHEROLE ST
Practice Address - Street 2:APT 4D
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4067
Practice Address - Country:US
Practice Address - Phone:347-399-7591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health