Provider Demographics
NPI:1447792122
Name:COMPREHENSIVE ELDER CARE, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE ELDER CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVOUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-447-1450
Mailing Address - Street 1:204 ROCKAWAY TPKE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1826
Mailing Address - Country:US
Mailing Address - Phone:516-447-1450
Mailing Address - Fax:
Practice Address - Street 1:204 ROCKAWAY TPKE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1826
Practice Address - Country:US
Practice Address - Phone:516-447-1450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2218L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health