Provider Demographics
NPI:1659972024
Name:CONSORTIUM HOME CARE INC
Entity Type:Organization
Organization Name:CONSORTIUM HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YUN YUN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-461-4872
Mailing Address - Street 1:2397B HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3148
Mailing Address - Country:US
Mailing Address - Phone:718-928-3886
Mailing Address - Fax:718-233-9693
Practice Address - Street 1:2397B HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3148
Practice Address - Country:US
Practice Address - Phone:718-928-3886
Practice Address - Fax:718-233-9693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health