Provider Demographics
NPI:1487866240
Name:INSTITUTE HOMECARE SERVICES, INC.
Entity Type:Organization
Organization Name:INSTITUTE HOMECARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SHOCKNESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-942-6780
Mailing Address - Street 1:23 NAGLE AVE
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-1405
Mailing Address - Country:US
Mailing Address - Phone:212-942-6780
Mailing Address - Fax:212-942-9183
Practice Address - Street 1:23 NAGLE AVE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-1405
Practice Address - Country:US
Practice Address - Phone:212-942-6780
Practice Address - Fax:212-942-9183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9381L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00921302Medicaid