Provider Demographics
NPI:1669045670
Name:COMPLETE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:COMPLETE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LONGO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:516-459-9288
Mailing Address - Street 1:3607 RAFTERSRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-3747
Mailing Address - Country:US
Mailing Address - Phone:516-459-9288
Mailing Address - Fax:
Practice Address - Street 1:3607 RAFTERSRIDGE DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-3747
Practice Address - Country:US
Practice Address - Phone:516-459-9288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health