Provider Demographics
NPI:1124006291
Name:ULSTER HOME CARE, INC
Entity Type:Organization
Organization Name:ULSTER HOME CARE, INC
Other - Org Name:ALWAYS THERE FAMILY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KOPPENHAVER
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:845-339-6683
Mailing Address - Street 1:PO BOX 1850
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12402-1850
Mailing Address - Country:US
Mailing Address - Phone:845-339-6683
Mailing Address - Fax:
Practice Address - Street 1:918 ULSTER AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-1344
Practice Address - Country:US
Practice Address - Phone:845-339-6683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00910930251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01005669Medicaid
NY00910930Medicaid