Provider Demographics
NPI:1629633763
Name:KAATSKILL ELDERCARE
Entity Type:Organization
Organization Name:KAATSKILL ELDERCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-373-9811
Mailing Address - Street 1:2000 COUNTY HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12474-1412
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 COUNTY HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:NY
Practice Address - Zip Code:12474-1412
Practice Address - Country:US
Practice Address - Phone:607-373-9811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty