Provider Demographics
NPI:1437548021
Name:PROFESSIONAL CARING HANDS
Entity Type:Organization
Organization Name:PROFESSIONAL CARING HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BROWN
Authorized Official - Middle Name:MADUBUKO
Authorized Official - Last Name:OGWUMA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:914-831-9694
Mailing Address - Street 1:107 GRANT AVENUE
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566
Mailing Address - Country:US
Mailing Address - Phone:914-699-5407
Mailing Address - Fax:
Practice Address - Street 1:129 VERNON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1811
Practice Address - Country:US
Practice Address - Phone:914-699-5407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAPPLYING FOR ONE NOWMedicaid