Provider Demographics
NPI:1124563820
Name:PRUDENT HOME HEALTH CARE SERVICES INC.
Entity Type:Organization
Organization Name:PRUDENT HOME HEALTH CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GODWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUMESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-790-0130
Mailing Address - Street 1:836 BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10474-5502
Mailing Address - Country:US
Mailing Address - Phone:718-790-0130
Mailing Address - Fax:
Practice Address - Street 1:836 BRYANT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10474-5502
Practice Address - Country:US
Practice Address - Phone:718-790-0130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health