Provider Demographics
NPI:1154635977
Name:ADJ WISDOM HOME CARE INC
Entity Type:Organization
Organization Name:ADJ WISDOM HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:XIU
Authorized Official - Middle Name:MEI
Authorized Official - Last Name:WENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-226-8218
Mailing Address - Street 1:230 GRAND ST # 2MFL
Mailing Address - Street 2:2MFL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4241
Mailing Address - Country:US
Mailing Address - Phone:212-226-8218
Mailing Address - Fax:
Practice Address - Street 1:230 GRAND ST # 2MFL
Practice Address - Street 2:2MFL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4241
Practice Address - Country:US
Practice Address - Phone:212-226-8218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1916L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health