Provider Demographics
NPI:1598744187
Name:PERSONAL TOUCH HOME CARE OF LONG ISLAND, INC.
Entity Type:Organization
Organization Name:PERSONAL TOUCH HOME CARE OF LONG ISLAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE COMPLAINCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLD-WEIDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-468-4747
Mailing Address - Street 1:222-15 NORTHERN BLVD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3603
Mailing Address - Country:US
Mailing Address - Phone:718-468-4747
Mailing Address - Fax:718-264-5834
Practice Address - Street 1:640 MONTAUK HIGHWAY
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-2115
Practice Address - Country:US
Practice Address - Phone:631-281-0157
Practice Address - Fax:631-281-1367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0130L002251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00420195Medicaid