Provider Demographics
NPI:1497948657
Name:NIAGARA HOME SERVICES LLC
Entity Type:Organization
Organization Name:NIAGARA HOME SERVICES LLC
Other - Org Name:HOME HELPERS & DIRECT LINK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-297-8585
Mailing Address - Street 1:7480 E BRITTON DR
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-1322
Mailing Address - Country:US
Mailing Address - Phone:716-297-8585
Mailing Address - Fax:716-297-3283
Practice Address - Street 1:7480 E BRITTON DR
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-1322
Practice Address - Country:US
Practice Address - Phone:716-297-8585
Practice Address - Fax:716-297-3283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1380L001251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02881767Medicaid