Provider Demographics
NPI:1750673679
Name:COMPLETE HOME CARE SERVICES, INC
Entity Type:Organization
Organization Name:COMPLETE HOME CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:DAVRON
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAGIMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-544-8163
Mailing Address - Street 1:10820 62ND DR APT 2B
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1213
Mailing Address - Country:US
Mailing Address - Phone:718-528-5493
Mailing Address - Fax:718-525-4305
Practice Address - Street 1:20514 LINDEN BLVD STE 204
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-2934
Practice Address - Country:US
Practice Address - Phone:718-528-5493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health