Provider Demographics
NPI:1790994952
Name:STELLA ORTON HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:STELLA ORTON HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BLANCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-313-1442
Mailing Address - Street 1:3155 AMBOY RD
Mailing Address - Street 2:2 ND FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2799
Mailing Address - Country:US
Mailing Address - Phone:718-987-4300
Mailing Address - Fax:718-987-7449
Practice Address - Street 1:3155 AMBOY RD
Practice Address - Street 2:2 ND FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2799
Practice Address - Country:US
Practice Address - Phone:718-987-4300
Practice Address - Fax:718-987-7449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0880L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00922234Medicaid