Provider Demographics
NPI:1467971135
Name:LIVE LONG HOME CARE LLC
Entity Type:Organization
Organization Name:LIVE LONG HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JING
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-351-4160
Mailing Address - Street 1:147-17 CHARTER RD
Mailing Address - Street 2:15B
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435
Mailing Address - Country:US
Mailing Address - Phone:1607-351-4160
Mailing Address - Fax:
Practice Address - Street 1:14717 CHARTER RD
Practice Address - Street 2:15B
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-6374
Practice Address - Country:US
Practice Address - Phone:607-351-4160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care