Provider Demographics
NPI:1760881676
Name:ST. XAIVER HOME CARE SERVICES
Entity Type:Organization
Organization Name:ST. XAIVER HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTABELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-725-9896
Mailing Address - Street 1:7235 112TH ST PR1
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5469
Mailing Address - Country:US
Mailing Address - Phone:718-725-9896
Mailing Address - Fax:718-793-8011
Practice Address - Street 1:7235 112TH ST PR 6
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5469
Practice Address - Country:US
Practice Address - Phone:718-725-9896
Practice Address - Fax:718-793-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies