Provider Demographics
NPI:1467990010
Name:UNIVERSAL HEALTH CARE, LLC
Entity Type:Organization
Organization Name:UNIVERSAL HEALTH CARE, LLC
Other - Org Name:AT YOUR SIDE HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-215-5320
Mailing Address - Street 1:10018 DITMARS BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-1326
Mailing Address - Country:US
Mailing Address - Phone:718-215-5320
Mailing Address - Fax:718-424-4970
Practice Address - Street 1:10018 DITMARS BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369-1326
Practice Address - Country:US
Practice Address - Phone:718-215-5320
Practice Address - Fax:718-424-4970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1214L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04530970Medicaid