Provider Demographics
NPI:1770023558
Name:HOME LIFE HEALTH CARE
Entity Type:Organization
Organization Name:HOME LIFE HEALTH CARE
Other - Org Name:ALVITA CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:ONGENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-273-0490
Mailing Address - Street 1:236 5TH AVE
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7606
Mailing Address - Country:US
Mailing Address - Phone:212-273-0490
Mailing Address - Fax:212-273-0499
Practice Address - Street 1:236 5TH AVE
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7606
Practice Address - Country:US
Practice Address - Phone:212-273-0490
Practice Address - Fax:212-273-0499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2071L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health