Provider Demographics
NPI:1154640670
Name:HOME HEALTH
Entity Type:Organization
Organization Name:HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:DARRON
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-401-6027
Mailing Address - Street 1:750 GRAND CONCOURSE
Mailing Address - Street 2:5B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-3106
Mailing Address - Country:US
Mailing Address - Phone:646-401-6027
Mailing Address - Fax:646-401-6027
Practice Address - Street 1:750 GRAND CONCOURSE
Practice Address - Street 2:5B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-3106
Practice Address - Country:US
Practice Address - Phone:646-401-6027
Practice Address - Fax:646-401-6027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297810-1385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care