Provider Demographics
NPI:1710198791
Name:MOTHERLY LOVE HOME CARE SERVICES, INC.
Entity Type:Organization
Organization Name:MOTHERLY LOVE HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FRANZESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-737-1788
Mailing Address - Street 1:45 BLYDENBURG RD
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-4301
Mailing Address - Country:US
Mailing Address - Phone:631-737-1788
Mailing Address - Fax:631-737-1441
Practice Address - Street 1:45 BLYDENBURG RD
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-4301
Practice Address - Country:US
Practice Address - Phone:631-737-1788
Practice Address - Fax:631-737-1441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0354L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01173959Medicaid