Provider Demographics
NPI:1477556199
Name:SELFHELP SPECIAL FAMILY HOME CARE INC
Entity Type:Organization
Organization Name:SELFHELP SPECIAL FAMILY HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WAHRMANN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MA
Authorized Official - Phone:212-971-7607
Mailing Address - Street 1:520 8TH AVE
Mailing Address - Street 2:5TH FLR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-6553
Mailing Address - Country:US
Mailing Address - Phone:212-971-5471
Mailing Address - Fax:212-290-8039
Practice Address - Street 1:520 8TH AVE
Practice Address - Street 2:5TH FLR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-6553
Practice Address - Country:US
Practice Address - Phone:212-971-5471
Practice Address - Fax:212-290-8039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7002651251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01559026Medicaid
7002651OtherCERTIFICATE OF AUTHORIZATION NY DEPT OF HEALTH
337407Medicare Oscar/Certification