Provider Demographics
NPI:1316575558
Name:HIS AND HERS CLEANING SOLUTIONS LLC
Entity Type:Organization
Organization Name:HIS AND HERS CLEANING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAQUANN
Authorized Official - Middle Name:ABDUL
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-867-6534
Mailing Address - Street 1:200 BROADHOLLOW RD STE 207
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4806
Mailing Address - Country:US
Mailing Address - Phone:631-867-6534
Mailing Address - Fax:
Practice Address - Street 1:200 BROADHOLLOW RD STE 207
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4806
Practice Address - Country:US
Practice Address - Phone:631-867-6534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization