Provider Demographics
NPI:1477715332
Name:CHRISTIAN HOME CARE SERVICE LLC
Entity Type:Organization
Organization Name:CHRISTIAN HOME CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:R
Authorized Official - Last Name:ANGLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-862-4577
Mailing Address - Street 1:1691 EASTBURN AVE
Mailing Address - Street 2:APT 1A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7828
Mailing Address - Country:US
Mailing Address - Phone:917-862-4577
Mailing Address - Fax:347-269-5040
Practice Address - Street 1:155U NEW BOSTON ST
Practice Address - Street 2:SUITE 166
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:781-975-6145
Practice Address - Fax:781-975-6145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health