Provider Demographics
NPI:1336481936
Name:GOOD SHEPHERD PERSONAL CARE INC
Entity Type:Organization
Organization Name:GOOD SHEPHERD PERSONAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-754-0631
Mailing Address - Street 1:1418 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3736
Mailing Address - Country:US
Mailing Address - Phone:516-362-2007
Mailing Address - Fax:516-362-2009
Practice Address - Street 1:1418 WILLOW LN
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-3736
Practice Address - Country:US
Practice Address - Phone:516-362-2007
Practice Address - Fax:516-362-2009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health