Provider Demographics
NPI:1467424200
Name:NIAGARA HOMEMAKER SERVICES, INC
Entity Type:Organization
Organization Name:NIAGARA HOMEMAKER SERVICES, INC
Other - Org Name:MERCY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / SAO CHS HOME CARE SVCS
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-706-2350
Mailing Address - Street 1:2875 UNION RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-1465
Mailing Address - Country:US
Mailing Address - Phone:716-685-4870
Mailing Address - Fax:716-961-1253
Practice Address - Street 1:2875 UNION RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-1465
Practice Address - Country:US
Practice Address - Phone:716-685-4870
Practice Address - Fax:716-961-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0744L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01293127Medicaid
NY02196532Medicaid
NY00887976Medicaid