Provider Demographics
NPI:1164014684
Name:SWING BEAN CAFE LLC
Entity Type:Organization
Organization Name:SWING BEAN CAFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF NURSING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEADOCK
Authorized Official - Suffix:
Authorized Official - Credentials:RN,NPH
Authorized Official - Phone:914-752-2102
Mailing Address - Street 1:45 KNOLLWOOD RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-2806
Mailing Address - Country:US
Mailing Address - Phone:914-752-2109
Mailing Address - Fax:914-747-7577
Practice Address - Street 1:45 KNOLLWOOD RD STE 102
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-2806
Practice Address - Country:US
Practice Address - Phone:914-752-2109
Practice Address - Fax:914-747-7577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care